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Form US (V) (e)
,(Rev. October 1993)
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I As provldsd by Ilctlonl 8321, 8322, and 8323 ef Iha Internal Revenue
I Cod., WI Ir. giving I notlc. thai taxtI (Including Inleresl and penalties)
I h.v. b..n .....ead .galn.t Ih. lollowlng-named laxpayer, We have made
I,' a d.mand lor p.ym.nl ollhl. lI.blllly, bul II remelns unpaid, Therefore,
th.re I. a lI.n In favor 01 the Unlt.d Stal.. on all property and rlghta to
. prop.rty balonglng to thll laxpayer lor tha amount 01 these taxea, and
I addlllon.1 p.n.ltll., Inter,sl, Ind cOIlslhal may accrue.
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D.plrtm.nl 01 'h. Trellury - Inl.rne' R.venu. Servlc.
Notice of Federal Tax Lien
Serial Number
For Optlonll U.. by Rlcord/nll Ol/lc.
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, 11 '1 ,U:Jf'C1
unlesl notice of lien Is rellled by the date given In column (e), this notice shall,
on the day fo.l!owlng such date, operate as a certificate 01 release as dellned <l,.1 'r,,>'IJ?
In IRC 8325 al. (Ill ~o"'.L'
Tlx Period Doll 01 Last Day for
Kind olTlx Endld Id.nlllylng Number Anlssmenl RelJllng
(a) (b) (c) (d) (e)
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This notice was prepared and signed al
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R... Rul, 74.466,1871.2 C,B. 408)
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Pori 1 - Kepi By Recording Olllco
Form 888 (Vile) (RBv, 10/93)
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Form Hl(Z)
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Dtp.rtm.nt 01 the TN..ury . Inllrn.' Rlvlnu. 8trvle.
Certificate of Release of Federal Tax Lien
D1.lrtct Slrl.1 Number
For U.. b RlCordln OllIe.
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I certify Ih.llh. followlng-n.med ".p.y.r, undlr Ihl rlqulrlmlnl. 01 IICtlon 11325 (.)
of lht Inllrn.1 Rlv.nu. Codl h.. ..II.llld Ihl I.... 1I.led below .nd .11 al.lulory
tddltlon.. Thlrefore, Ihl lI.n provldld by Codl IlCtlon 11321 lor Ih... I.... .nd
.cldlllon. h.. bttn rel"led. Thl proper olllclr In Ihl olllcI whlre th. notlel 01
Inllm.1 revlnu. ... lI.n w.. IlIed on
I I. .uthorlzed to not. Ih. book. 10 .how Ih. rei.... 01 Ihl. lI.n lor
Ih... ..... .nd .ddltlonl.
N.m. 01 T'.ply.r
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This notice wes prepared and signed al
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day of
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(NOTE: C'tlifica'e 01 olf/eftr lIu,horllMJ by law to ta~8 adno~ledgm.nf.l. not "uenliat to ",. \'tllil1lfy 01 C"rtiflc",. 01 Rel,au 0' F.d.ral 111. I." Rev, Rut. "..,60. '971.2 C.B. 409)
PART 1 ' RECORDINO OFFICE
Form'" (I) (RIV, 8-87)
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