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�JU� 15 '99 �7�22AM U.C.0 DIVISIUN • .2:'2 <br /> -. ti . . <br /> FOrm 868(Z) _iQ� - . _ _ - -� - - i� . _ _ ._. _..___ _ <br /> ' =tpw.e��� �.��17 . <br /> DlstNet �m �� � or U�� n <br /> dma�� 47950 t�i 1 flLE� <br /> I csrtliy thut the tollowlna-named taxpayer,under tlw r�qulrement'pf soctic►n eaza(� NE UG� DIY <br /> o+�,e �n�ernai �ovanw Codo haa s�tlsNael th� uxo� 11it�d b�low�nd o�� rt�tutory 99 Jl�� !4 A� � { <br /> addltlans.7'herelae, the Ilen provldsd by Code seetlon �1121 for thesa u:eo and ' <br /> addltlone t►as been re�eaaed. Tne propa� afflaer�i��th�e �e� wnere the noda� o� 5ECiY StA1E <br /> Intetr�y�cenue tax Ikn was!lled on � <br /> , !e suthorl:ed to note the beoks ta,ahaw !he release o# thls Ilen tor <br /> these ta�es and add�lon�. � ' <br /> N�e of 1'�xpayer AtV i�! A $qRER <br /> Resldence �v��s�;,,�YS���� 9�9 1 � '7 0�7 <br /> C[�UitT REC;Of�DlNG IN�GRMA'PI�N: `�`�'�� �� ��� �r� �",�., •��` <br /> L i D�r Pagp iJC:� IVfi. 6rr i�I No. � <br /> r�1 a n!a n/a 9!a-�43901 Q'��~t0?j�� <br /> Kind of Tax Tax Ppriod End�d Identliying Number �g�� Last Day for Unpaid Balance af <br /> (a1 �) ��1 Asaessment Refil�ng Aasessment <br /> (dl (�1 li? <br /> 104� �W��1/1���'� 5Q3-•S4-�g�'� , 11�t�Jt�'�� �?'/i51�4�►:� 5i�?�.�s� <br /> �t�ti���r�r« *1�+a*a+►�+F*i�� �i*�F�**�i***w� �a*�a���a��5�a*iF* *1a�P�a�a�+a�a*�a�a�i ��*��c�iF�Fi��F*��ki�*�r�r <br /> . i <br /> T � . � � <br /> RMIN .°�E� <br /> Piaoe of�ilrn� � <br /> Ft�g i ster �P Derds � <br /> Fi�.i 1 t`G�t�?: !6:�2 � 3 51:2T�.� <br /> Grand i� i.�n�rt Nfi �,8��7�-I��Z <br /> r <br /> This notice was prep�red $nd slgnsd at a"Raha. NE ___ _ _ __. , pn ihts, <br /> the '���h dSy 01 ���� 1'A95� <br /> � <br /> Signaturo ' ` " ' ' , Tlilo <br /> �ni��, �.F-.�. 8��$�3 <br /> (NO7E:CerYMCate vr on/cx aufhartaed bY�w ro tal��ments 1a not essenGie/ro N�e�sIMl�of G1ertKlcafe of RNaase ol r�ahiaf fl�r I�rr Rev.Auf.71•16B, 197l,8�d.409) <br /> Pia1eT�-qECOaoiKO oPF�C! Form Pit�(R�6-�T <br /> I Clil:N0�6�R <br />