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D.plrlm.nl 01 Ih. TIIDlurv . Inlernal Revenue 6lrvlc.
Form 688 (V) (c) Notice of Federal Tax LIen
(Rov. Oclobor 1903)
Dlstrlcl Serlnl Number For Opl/onal UII by RlCorcllng Ollie.
II 'I') - ')') .)'l ':-11..-
A. provld.d by IIcllon. 6321, 6322, Dnd 6323 01 the Inlernal Revenue
Cod., We .r. giving a nollc. Ihal laxes (Including Interesl Dnd penalties)
h.ve been anlSlld agalnsl Ih. following. named laxpayer. We have made -
I demlnd for plymenl of Ihls liability, bul It remains unpaid. TherefolO. ,
Ih.rl I. I lI.n In favor of Ih. Unlled Slales on all properly and rights to
property belonging 10 Ihls laxpayer for the amounl of these laxes, ond
Iddltlonal panalllll, InlerlSl, and cosls Ihal may accrue.
Name of Taxpayor
,
Rosldonco c.r:,
..,.,
, IMPORTANT RELEASE INFORMATION: For each assessment listed below. '1'1 Lf. \ rl
un loss nollco of lien Is retHed by the dale given in column (c), this notice shall,
on the doy fOllowing such date. operate as a certificate 01 release as defined f..'.I'.J \I'fd'~
In IRC 6325'0), t1... t1 ">10 1'/ ,
Tax Period Data of Lasl Day for Unplld Ballnc.
Kind OtTIX Ended Id.ntlfylng Number Anenmenl Reflllng of Anenm.nl
(8) (b) (c) (d) (e) (f)
,
Place of Filing
Tolal S
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This notice was pro pared and signed at
, on this,
Ihe
.'>"",~, ~"'''.~.''';'',I 1,- " ~
day 0' .19_.
B,gnat~~_b)~:.J.~. '/
Title
(NOTE I ellUl/elll 01 offlnr authorized by 18~ 10 like BcIo.no",lelJgrTl.nll I, nol I",nlial to the YltldllV of Nolle. 01 Fld".1 Tax IIln
A.v. Aul. n4lS. "~t.., C.D. ~OS)
Part 1 . Kepi By Recording O"lco Form 668 (V) (0) (Rev. 10/93)