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Form ~;~~ DeaartrtfeM of the Treasury - fniemat Revenue Satvlce <br />nrY ~e~:em a~y¢~ -#~c~ ~r# F~der~l Tax Lien E~nd~r I~t~rnaf R~v~n~~ Laws. <br />CiSYfiC3 ~ sart8t ~YUitt(~ar ~_~ F r OPilanaF Usa DY •'tecordirtg Otf+ca <br />As ;yrov7£,ed hu secti:,.~,s 6:~21,`£+~22, and ~E323 of the !n#ema! Revenue Coda, <br />notic:a is given inat.^ tires ?i>~iciitd't~g `iRteerest and penattias} Nava Mean assessed <br />again^st ina fdPYOw~r.<a-ner~d taxpayer. '.Dainand-for payment of Fnis tiabiiity has <br />bean made, ~3 it retrains t.rsrapaid. Tneretora, t:t8re as a Tian in favor Df me Uni#ed <br />Sates prr ~t~OA~t'K'ar?dhtS,tQ cY9r,Grty tsefiortc~isag .o *.nis taxpayer #Qr the <br />amount of k3x~ an ad~'~ona, panalti2a, interest. artd costs that may <br />awe. <br />name gat taxpayer _ _ ----- ------; <br />.rY - :i.~.. - ~ -, .. . ., zs~ .w.._... _,. <br />Re~cfence- -- - - ~~- --- <br />i <br />.r'.r -~ u'": p .. ~ _ . <br />~~' ~~ t` - <br />f <br />K{AdTa~ Tatc Tauc P!i'lQd ~ ,5 ~ d Identflyirtg NUPTib@rr <br />Ca; # 'c) f;Yj <br /> <br />Ot Alf/N{t <br />ral <br />~" ~ r„ w . . <br />TneS P,8::C8 YVd$. 8nd .' ~ ~ .. - .. _''P`' _. <br />at .. _...,.,,.. ... .Y ... _._,. <br />the _ ~, c:ay c; . , _. _ .._ ,1$ <br />tSrfthi5, <br />neturG --_ .-~_T_... _...... .,._._._,_...__,_._,_~_ _._.__..._ <br />... ,~t. ~Z,. <br />.,. <br />_ ., . <br />___ <br />Mm9s ~-^-...~.a...^w._ <br />f =.'9 zil n~ <u's ~' F2.6d 'S~ '$W PO 6b&s bGAri~'w'f>,}3n(ta ry r u= 5Tiz4r't:&1 {~~ 2tx0 v&tMltty_ at Nwixo rJt <br />i'bL1Mi:''t. _'Sn (i L3 f6O'. tYI M++`", I: $. 175.k <br />Fart i - 7o be ~u9Pt t+p reoordsrgz atiies , >r»aar, t'i88 iFttav. 9-i°8) <br /> <br /> <br />