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__.__ _. <br />l=oon ~~~~ <br />(9qv. sdP`ember 19781 <br /> <br />pepartmenYOi th@Treasury-Internet RBU0nu08erviCe <br />Notice of Faders! Tax Lien Under internal Reuenue Laws <br />~~152riCF -- -~ ~ Je' rral {~;umbeC ~ F6T OPMPneI'Use by Aecmrting Othi-n <br /> <br />40825 <br />'._- <br />- As provided by set;ficns 6321, 63?_2, and 6323 0} the internal Revenue COd@. <br />notice i!s oiven 4hst taxes lincludin9 interest and penaltiE53 have been assessed. <br />against t:~e fcliowing-named taxpayer. Camand for payment of ittis-liability h8s ~V i ~~~ <br />1 ~7 <br />been ma~'e. but f? remains unpaid. Therefore, there is a lied Sn favor of the l3nited SG <br />States nn ail property and rights. to pr: aefij betanging to this taxi3ayer for the <br />amount of chess tzxes, and atfditionai penalties, interest, and casts that may <br />accrue. <br />Name of Taxpayer <br /> <br /> <br />Residence <br />- l <br />; <br />`~ 7 <br /> UnPald Balance <br />Kind of Tax ~: Ta= i+erbd Ended I Dates of Asssssmani ' tdeMNyir~ Kumber # of Assessment <br />(N fbF S ic} r~} i ie) <br />1 l <br />1 j <br /> <br /> <br />1 <br /> <br />t <br />r <br /> <br />i <br /> <br />Place of Rung .., <br />~. ~.., z _ _.._, , ..... _~_ r <br />This notice wee GxeOared and xgned at ._ = _~ ~ =ir ~~r';.____---~._---- ~-.-,-~_ -----..--, on fr~is. <br />the "' .day of ~__-_ t9 ' `_------ <br />Signature y ,~~,~~.~~-, T .ie <br />fr1aN: : en,r.rare c+ ;.!S(y~ •iaharuae by #swra fs:ur tCk~iUwP~r/(jd+fshf; ii rspr atiMEi!! +n 31+e vetirtify o! ?l O++r-.e or <br />ca]vN re: :.r. LCN 2WiK lfl50~:. C,$ 7?5) <br />Psrt t - To be kerpt by recording offitx F{!rm $60 lRev.'~-~fj; <br /> <br />