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I <br />Form ~ GRpartm Prrt offhe Trg>l~try - ff11lTRa1 RBValrrab Sbrv~cb <br />WV ~ <br />fAev 5eptembsr,9,8,( Notice of -Federal Tax Lien Under Internal Revenue Laws <br />-~ _ <br />District Serial Nu/m~Ckter For Ocrional uae py Raeortling OfHCs <br />A3 prcivided by sections 6321, 6322, and 8323 of the rnt,3mal Revsntte Code, <br />notice iS given that taxes rinc(ading interest and penetties) have been assessei <br />against the foiiowing-Warned-taxpayer. Demand for payiT9erlt of this liability, has ~ ~ ~ ~ ~~ lj _l ~ 5 <br />bean made, but it -emains unpaid. Therefore, tt>zce is a lien ir. favor afYhB United <br />States an aU property and rights ?n property belonging to'this taxpayer-foa the 9 <br />amount of these taxes, and additfon2l genaities. inberESt; and cosfs: thaf tray <br />accrue. <br />Name of T2xpayer <br />Residence <br />,~ ~ ~ :'s'ir .:;r....,. ~ ~ ~ _ <br />' ' Unpaid Bala~fp <br />Kind W Ta: ~~~ Tai F'erfud F_ndgd ~ oft i idenNfYin4 Number ~ of Asaessmant <br />fa) ~ !b1 ~ !c3 I. ftlJ , <br />I. <br />f <br />1}1~t <br />;~ <br />1 <br />E <br />i <br />l , <br />y~y ~ <br />~ I 1 ( <br />~ 1 <br />! ~ ~ 1{~ <br />Prace O{ t=iling <br />?ems ._ F <br />Toca I s . <br />-~ _ ; _ . , <br />~; <br />This notice war. prapared and signed at _ . --- ' :: - '---:--1-;- _=-_-~~ ._.~_ ~_:.~_~.._ . cn this. <br />~_ ~r day of - - ..8 <br />~ --- <br />---..___ '-- r-- - ~ ~ <br />__ --~ ' - <br />Signature ~ ~ _ ~~ .~ Title ----- - -- - --- <br />~/ ~ _ <br />(Hair. Cantn,t» or o1r.o, au:rw-r±' Py =a er ..> 's,Fe fYkbDwfao¢.rpons _. o-sse~ r , .~ Lne ~4~6i,;y or 3Joe:cn or <br />F~Wrti Yy~ Lei G. u. M. :St;9, ":~S J-'. C.B. '25.? <br />Psn 7 - Ta be kgpt:hry te[yDrgi6lg offing f,rrn 868 iRe~. 378 <br /> <br />