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De~lrtmlnl 01 Ihl TIIDlury . Inlernol AvvenuI 6ervlcI
~orm 688 (V) (c) Notice of Federal Tax Lien
:Rev, October 1993)
District Serial Numbcr For Opl/one' U.e by Recording Ollie.
I" f') ')1) 'II rTL
AI provld.d by ..ellon. 6321, 6322, and 6323 01 Iho Internal Revcnue
Cod., we ara giving a notice thlt taxes (Including Interosl and penalties)
heva bean e.....ed agelnlt the 'ollowlng.namad taxpayor. We have made
a d.mand for peyment of thll liability, but It remolns unpeld, Thore'ore,
th.,. I. . lien In favor 0' the United Stales on 011 property and rights to
I property b.longlng to thl. taxpayer 'or the amount 0' thoae taxea, ond
!
additional penaltlea, Intereat, end coela that may accrue,
Name 0' Taxpayer
Residence -
.,
LJ .
IMPORTANT RELEASE INFORMATION: For cach asscssment lis led below, il' Ill,' \ ,I
unlass notice of lien Is reliled by Ihe dale given In column (c), this notlcc shall, \ ~ ~ " II I'll' I
on the day 'allowing such date. operate as a certlflcatc 0' rclease as dclmed
In IRC 6326 a). . ,:.,\ .\L~~l ({
I Tex Period Date of Lest Day for Unpaid Salanea
Kind of Tex Ended Idantlfylng Number Assessmenl Reflllng of Aeaellment
~ (a) (b) (e) (d) (e) (f)
\
,
Place of Filing
Totsl S
This notice was prcpared and slgncd al
. on this,
day of , 19 _ '
. ....~.._...~~~,1#4~.....!',.!
Tit'e
, lulhorlnd by law 10 lake acknu....leagm.nll t. not 81unllallo Itle y.II(jII~ 01 NOllce Dr Flde'I' TI.II'"
_091
Port 1 . Kept BV Rccordlng Office
Form 668 (V) (e) (Rev, 10/93)
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