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O,pullmenl of Ihe Treuury . Illlurnul Revunue Service
Form 668 (V) (e)
(Rov, Oclobur 1 n03)
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Notice of Federal Tax Lien
District
Solial Number
FOI Optlonl' Ual by RIco/ding Olllc.
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1\ll', 'il!, ~" r,") 1) flL.
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AI provld.d by ..cllonl 6321, 6322, ond 6323 01 1110 Intornol Rovonuo
Cod., w' Ire giving I nollc. lholloxos (Including Inleresl und ponalllos)
hlv' b..n .......d agalnsllhe lollowlng.nomod loxpayor, Wo hove modo
I d.mond lor Plym.nl 01 Ihl. 1I0DIlIIY, bul II remolns unpold, Thorelore,
\herl 'I . lI.n In Ilvor 01 Ih. United 610tu on 011 proporly ond rlghls to
prop.rty b.longlng 10 Ihll laxpoyer lor Ihe amounl 01 Ihon loxes, ond
.ddlllonal p.nllllal, Inler08l. and coslslhal moy occruo,
Name of Taxpllyer '>O'lil" , 'I !,"','II
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IMPORTANT RELEASE INFORMATION: cor oneh "nses~1l1ent listed bulow,
unless nollce of lion 15 tollled by \110 dolo glvollln column (0), ill'S notice shall,
on the day following such dole, oper"lo os 0 COllilicnle 01 releaso as delinod
In IRC 6325(a ,
Tex Period
Ended
(b)
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Kind 01 Tax
(a)
Idonlllyln\l Number
(e)
Dole 01
Assessmont
(d)
Losl Ooy lor
Rellllng
(e)
Unplld Balanc.
01 AU..lmlnl
(I)
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Ploce 01 Filing
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Tolal $
.1,/:".1\
This nollce wos prepsred ond signed at
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f'lhe ,.i'''tI'~di9'm'':'''';''''~''''' ,'19~~
Slgnalur~ ,," , ' 9 / I Tille
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(NOTE: C"tlllcill. of oWc'u Dulhorlzlld by luw to lO.ko acknowtuogmonlll III nol usentlallO lho lJoUdlly of NoUc. 01 Fldl'll TI.lC IIln
Aov, Aul, 710466, 1971 ,2 C,B 400)
ParI 1 . KepI By Recording Olllce Form 668 (V) (c) (Rev, 10/93)
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