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Form 668 (Y) �c) .;�; ; :�.� Department of the Treasury-Internal Revenue Service
<br /> (Rev.Aug�st 1g9� Notice of Federal Tax Lien
<br /> District Serial Numbef For Optlonal Use by Recording Olfice
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<br /> As provided by sections 6321, 6322, and 6323 of the Internal Revenue �z; "�—��3���
<br /> Code, we are giving a notice that taxes (including interest and penalties)
<br /> have been assessed agalnst the foilowing-named taxpayer.We have made
<br /> a demand for payment of this liability, but it remains unpaid. Therefore,
<br /> there Is a lien in favor of the United States on all property and rights to
<br /> propeFfy belonging to this taxpayer for the amount of these taxes, and
<br /> additiaial penalties, interest, and costs that may accrue.
<br /> Name otTaxpayer
<br /> ; r�:7 C�:C:!_f-: ._; �f�i tlJ�:k:1 IVt; I lue�� a C=;:�r y;c,r-a t i �;r�
<br />• Residence
<br /> � �.�: �� {_n!
<br /> Cal-;l�1�!T) �C:;1_..�1'�a:i:? :< f�JE. r�;s�:;;-;c::f::<�-`r"�;ii:�•;i
<br /> IMPORTANT RELEASE INFORMATION: For each assessment listed below,
<br /> unless notice of lien is refiled by the date given in column (e), this notice shall,
<br /> on the day following such date, operate as a certificate of release as defined in
<br /> IRC 6325(a).
<br /> K1nd of Tax Tax Period Ended Identifying Number Date of Last Day for Unpaid Balance of
<br /> (a) �b� ��� Ass��)ment Re�e�ng Asse f inent
<br /> ()
<br /> ,�r:� 1 1 � � :.
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<br /> ..�.� t ; ..��i���_ .:�!�i'j'=r '•• ��, � � �`, � � .
<br /> -,. 1 ,. , 1 �. . . � :' � r�C _ - .•� � • „
<br /> , :1 , :1. ; _ •=�,�. �; _r-, :c.._,,_> -r , , - ,,�,,:-,
<br /> _ 71' ..�r . (')'; , ,_... i ':`,, �
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<br /> Place of Filing
<br /> ���;�.;,a � =:. t;a::,F �;f i?i�E��.i�;
<br /> Total $
<br /> i-1.;. 1 I �_ ,+;r, i-.y
<br /> r:: ,, i _ _ t ,,_ ',� . ..�:.,
<br /> ���
<br /> This notice was prepared and signed at �i1�y.+:��a� �� .� �aEr
<br /> , on this,
<br /> the�-i-
<br /> day of J'�i:.r..�.. ri � -.:�...f;:.
<br /> � .
<br /> � .
<br /> Sign
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<br /> } �r ���1C:Fi�E�L I�'�:�r�l'!°�_. --
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<br /> (NOTE:Certificate ol ollicer authorized by/aw to take acknow/edgments is not essential to the validity ol Notice o/Federal Tax lien Rev.RuL 71 466, 1971-2 C.B.409)
<br /> PART'I-KEPT BY RECORDINQ OFFICE
<br /> Form 868(1�(c) (Rev.8-97)
<br /> CAT.NO 60025X
<br />
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