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i <br />.La~ ,~.,..t~< <br /> _ <br />gp~nm'erit`of the Treasury • Intemei Revetnie~Servfce T- <br /> farm MM <br />i ~41 r } f ~ .~~~ r.~-;•Y - <br />' t~ F~.,~j l~ce <br />o# Fe~~'a~ Tax Lien Under Irrternal:Reaen~ laws: <br />- <br /> ,. <br />- <br />-- <br />- ~ <br /> T Fa tpucnarUsa~tiy RacorGng Via' <br />._.... , <br />1 Sdnai N~. rTltigr~ <br />Distrfnt - ----- - <br />- <br /> ~ i a /- ~ 45906 - , ~ . - _ ~ ~ <br /> Aa ptovtd~'d by soct(ons 6321, 6322, end 6323 of the Internal Revenue Code; y <br />enalties) have heen ' <br />Intetetd"s;rxJ <br />1nCtudin <br />itul t <br />xe <br />i <br />l <br />t <br /> , <br />p <br />g <br />ven <br />a <br />s ( <br />not <br />ce <br />scg <br />asaesa~d s~gainst thesiflligrring-named taxpe~ I]emand for payment of <br />this Ilablll has teen"made; tAtt.it retnaitte~i Therefore, there Is a Iiert , <br />~~ ~~ i <br />~ ~ a 2 <br /> ~ <br />In favof of the United States on altpttsperty aad Hghts to property bebnglifg .- ~ <br />d <br />i <br />id <br />ddtt <br /> a <br />ona <br />pena <br />es; <br />to tttls,taxpayer flu itte amount of these taxes; an <br /> that rrtey accrue. <br />Interemt, and t:oats <br /> ~4 <br /> ~ <br />s--- <br />Name of TaXfSayer <br /> . sill lF;giC3, 4~t;: {. 7",~,~ 4. 31 .r +. ;i {~. E; - + <br />l <br /> ~ -~----il <br />..~c.t..~ <br />Residence- - <br /> L c .- f'! C 3°-', is [ L : t <br /> <br /> "1R7PORTANT' PELEASE INFORMATit1N Wdn res{~eetio each. assessment listed oe~fow,uniess <br /> noftGe ot. lign I§ retited'6y utiedaze. given ~n colamn (e)- this notico shall. on rile day tollowing <br /> .au0ttdat9.opera;sas.acenil+cafe ofrelease as defvted in 1RC 6325 (aj. - _ <br /> ' TaxPeriddI Date of ~ Last Day for !, Unpaid9alence <br />- _ -ttlatiof Taz Ended Ident;tying,Numlaer I Aaaeaement i Refiling '~. of Asaeaement <br /> <br /> yay I try-3t4-t , il-,_..-;:.i. ~..-/_.^;~J I ~/-. .. _._ <br />T <br /> -_ 1 l i~ -. .~ ~ - ~ iii - <br />- 1 <br />~. - <br /> ~ <br />- -o!i ~ - k~._i <br />J~ I <br />1~~ .~. -_. `ice ~ -- - <br /> t <br />} <br />J <br />L <br /> <br />- <br /> <br /> <br />- f <br />1 <br />V ~ 1, ~-~O ~ _ 3i <br />~ <br />>.~ i -,y -' f I <br />- { t i ~ - <br />.. ~ I - <br />~ ~ ~ <br />- j .,. ~ ~ ~ .. - - _ <br /> I , ~ <br />_ ~ ~ } - ~ ._ <br />{ <br />y l{ <br />1 <br />~ <br /> .~. <br />_. - __ <br />- <br />P~~FlGn9 --T" _ _ _ --'- <br /> <br /> <br /> ~- ~. ~~~. <br /> Thi8El4tM:ewa&RFaRaredatW8+gn8dat_____,_ ~_-~-T--- .f-.c-.-----,..,,..::,,OtttFiis. <br /> ~~ ~~ ~eC~tk4~r- :~3 <br /> -the daypf, -- , t9 _____ <br /> Signature mwG~~<~'~~~ ~ ~ jTitlB ~ ~ ----- <br />i <br /> _-__ :li ~ ~c~i}:Y i; L~~ v.._ f:~_l.._~ ~_.~ -.rJUe. "r__._____..~__..__ ___ <br />_s ,--._...s - - - ~_..._..~.. - <br /> jtiOTE; tasr{~a(eWOeket eiltlq?rLted,Rgfaw tefeke BCleiew/etlgrnNttSfsrWt e55enUld(O thB.Velldlty0l Notice ofFetlerM Tax Lien - ..:..; <br /> Rer- RuC 7!.186, ~F7=2; C H Stir - - - <br /> Fart i - To tie-tCei~hy iisCasdiftg ()ftla:e <br /> Form 888(G) (Rev: 2.831 <br /> <br /> <br />F _. - <br />~~, <br />