HomeMy WebLinkAbout95-06268
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Deplrtment 01 the Tr..'ury . Intllnl' Revenue Service
orm 868 (V) (c)
Rev, October 1993)
Notice of Federal Tax Lien
For option.' U..lly R.cordlng Olflce
Serial Number
qj'- UU/( -r1L
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AI provIded by ..ctlonl 8321, 8322, .nd 8323 of the Intern.1 Revenue
Code, we .11 givIng. notlc. th.t t,XII (Including Interllt .nd pen.ltllI)
hlv, been .......d .g.ln.t tha followlng.nam.d taxp.yer. W. hava made
. d.m.nd for p.ymant of thl. lI.blllty, but It ramalnl unp.ld. Therafore,
there II . Ilan In f.vor of the Unlt.d Statll on all prop.rty .nd rlghtl to
prop.rty balonglng to thl. taxpayer for the .mount of thell taxII, and
.ddltlon.1 pan.ltllI, Int.r..t, .nd co.te th.t m.y .ccrue.
'Name 01 Taxpay.r , ""i'o' ,\ I1U!' "j,
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b ~, 3141lt
Unpaid Sal.nc.
of A.....ment
(f)
IMPORTANT RELEASE INFORMATION: Fer each assessment listed below,
unless notice 01 lien Is rellled by the date given In column (e), this nollce shall,
on the day following such date, operate as a c.rtlflcate 01 release as defined
In IRC 6325 a .
Tax P.rlod
End.d
(b)
Date of
Assllsm.nt
(d)
Last Day for
Reflllng
(e)
Identifying Numb.r
(e)
KInd of TiIX
(a)
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Total $
Place of Filing
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This notice was pr.pared and signed at
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, day of
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(HOTE. c..t1t1c.l~ol pille.' .ulhorlzad by I.w 10 I.k. .cknowl.dom.nl. II nol ....nll.IIO th. v.lldllV of Holle. 01 F.d...1 TIl lI.n
R.v. Rut 71~ee; 1811'-2 C,B.'400)
,.. .. ,... .._.... Part 1. Kept By Recording Ollie. Form 668 (Vllc) (Rev, 10/93) u