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<br />
<br />~menl of the T....ury -lnt_1Il Revenue Service /
<br />Form &II&) ~;:~::. ~~; "
<br />
<br />(Re. Fe!>, 1983) jltJtfdof FedeI. Tax Lien Under Internal Re..1.awJ
<br />bj~--_____L_. --'"----=~.--:}~'N~r .'------------;--- ForOp/ioo>all1#!tby~~
<br />UnalHt 47.'"."._~~'" "_8123 06B :;54. /' '
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<br />----".-"-----~,~L--;.""i__---..--------_____i
<br />
<br />A8...~...... ...'.... by~.$32.'t:'6322.' ,and.:=..........C-....',...he. ..,...tnternalReve. nue. .Cod.'.'; ,
<br />nodW E t,*. . t_. . (InCluding I. ,.' ','"'.','._.. '.' ,.' penalttes) haw'been,
<br />nil...... ."'.' Illt the fo.tIowl.... .,.... named. ." . ............ ' ",' . ,CI4Nnart. .' d for P8Ymerrt.. of
<br />ttn~ ......,. m<<Id&, lJutJt'1'eInaItJ......Tb.refor., therelaa lien
<br />In flwOroftheUnked ~ on IlIIpropel1y ancfttJhtS to property befonglnf
<br />to tfll&t~ for the amount of these tu~ and addlttonal penaltlu,
<br />Interat. and C08t8 that may accrue.'
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<br />"Name'O/Taxpayei--
<br />uorer, tiern~rd H. Jr.
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<br />Residence
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<br />," 684911
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<br />lti07 SY.' front
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<br />vtiotii
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<br />; ~A.Nt:'~INf'ORMArIOW Wilh r.peel (0"'-,_ listect_,unlesa
<br />,,"!lOIli::e'of~,is .I~.l;y ;he.lUll<Qli'.lm ,n "olumn I,e), Tn", r""><:<l shall, on ,he daytol!oWir.g
<br />.'_....QllllfIII.._~I>I,_.....llSd"j"'ed'ir>IRC6325(aj
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<br />f5"'23-IUl
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<br />T_~ j l Dated
<br />.Ended ,ldentifyfl'llJ"NumillIlF i ~llIIUISIIM!J!f"
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<br />t.~31-19 .--: ~il5":':64-:i7i5-"~~":l!3:if4
<br />12-31-IU " ~.-~.-.4
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<br />~ofi'1iio.g. ."~"
<br />keglStef' of lJeeus
<br />liaJ.l COUllty GrllllU
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<br />ThiS notice was prepared anti sIgned at n
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<br />Llllalla i-le.iJl" as ka
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<br />'''n"~,____,_"..~__,.."_~, Ol'l.lltl$.
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<br />!tJ,~~::..". day Of=~~=f'l~~ ~ , 9b~ ..
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<br />- "'71 .. in l;.-/y::; ..
<br />i.~><A,:'"L& d . z.. tfGte&..... .. "
<br />~~,i.~,~).~______J,_~_._ ,~I~_ ~_~t_~
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<br />Tille
<br />
<br />Signature
<br />
<br />Part 1 -, To 00 "apl >-'y HllOO!dinu Off""..
<br />
<br />FOr", 6ft(C1 (Flev.. 2,83)
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<br />fMO'tS; C$tlJtJca:e of ~ dUlht'Y.l:OO by ktw. to raM d!..'Jc;fJ.(~~roS is nO! 9S$eflfi:$! Y'; f~ ..ahdrty Of NotK.'1J QfFederili 1!j~ L"'fffl
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