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<br /> <br />. ____ <br />Form ~~ Department of the Treas. ry - Intorn al Revan ua Service <br />(Re¢6optarcrDer,97a;~ Netice of Federal Tax Lien Under Internal Revenue Laws <br />district - - - - <br />Senal Number For Opr;onr,l Uae Cy Axorning Orrice <br /> <br />-~c=~ i 40979 i - <br />~ <br />- I <br />Qs_prorided by seCiions $3?_1, 6322, and 6323 of the Internal Revenue Code. <br />notice is given that taxes mclud ng interest and penalties) have been assessed <br />agarrist the following-^amed taxpayer. Demand for payment of hls Ilabllity has <br />beer'tl'made. bu$it remains unpaid Therefore, here is a lien m favor of the. United <br />States on all <br />r ~~_ .. p ~~ ~ 2 g 7 <br />p <br />operty and rights to propert7 belonyiny to this taxpayer for the <br />amormt of these taxes, and adaiitioftal penalties, interesi. and costs that may' <br />accrue. -~ <br />Name of Taxpayer <br /> <br /> <br />Residence <br />_,__ ,_ , .._ _ .~ _ 1 <br />! <br />_ <br />~ <br />Kind of Tsx ~ Tar. Period Ended bate of Assessment ; Identif <br />in <br />N <br />mbe <br />~ Unpaid Balance <br />~ <br />y <br />g <br />r <br />u <br />UJ fe7 i (c7 i [CJ - 01 Assessment <br />~ ;eJ <br />q i , _~~~ ~ ~ ~ t ,~ I - _- ~ - - <br />~ <br />~ <br />4 <br />~ <br />l <br />n~_ r <br />r <br />~-131 ~ ~ <br />~ <br /> <br /> <br />f ~ <br />?lace of Filing _ _ -_, <br />u~~ u <br />This notice was prepared and signed of s='°~:. __`L__ _ _ _______ _ _-_-____ , on this, <br />the :"' ~ day ofd; 19 ~.: <br />Signatur ----T - ----- -------._ --- <br />, i?le ------- -- <br />+/~-~~~~ <br />- 'v _ _ <br />iNOla: ['an t~cete v! ofliter eu7f:orizad oy Asw fo take AtknowfsOpir ;u±s n~i ,antral ro the ve,"id/ly c/ Notko of <br />FW.~rri Ya+ .isn G. C. M.. 2(A i6..18$rj-2, C.8. i~5.j <br />Pert 1 - To be kept by record'mg office Foein $$8'iRev. s-?s} <br /> <br />