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h•~„~ 3~a ~J• 1'R~k$(,IRY ~EfARTMf~1T ' INTERNAI REVFNUE SER'VICE Fer Oplional Ib~ ~y R~cadinp OHie~
IREV. 4•65~ NO~1CE OF' FEDERAL TAX UEI~ UNDER INTERNAI REY~ItIE LAWS
DISTRICi ( SERIAL NUMBER~ "
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Pursuont to the provisians of Sections 6321, 6322, and 6323 of rhe Internal Revenue Coda, ~
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notice is hsreby given tttat there have been atsessed under the Internal Reven~e laws of the ~
United Sfates aflainst the foilowing•named taxpcyer, faxes Iincluding ~nterest and penalties) whicSi ~ ~
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after demond for ~uymerN ther~of remain unpaid, and that by virtuc ~ above-mentioned (?-~Q
sfatutes The amount nf seid taxes, togetht; with penaities, i~tarest, ai7d costs that may occr~e
in oddition fheroto, is a lien in favor of thP ;;ai1a~ .°~iatcs .~pon o'! pr~sccrty and rights to property ~`.~,."4 ~
belonging to aaid taxpayer. ~
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NAME nc -r~xD4YFR----- - - ' 1
W
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T2'~ ~ Qs O 0
RES~DENCE OR PLAC~ OF &USINE55 ~ ~ ~
906 g. z5th st. ~ v~
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~ASS pf Yq)( UNPAID BAtfU~CE ~
(Tax Retum Forrn No.) PERIOD ENDED ASSESSMENT DATE IDErFTIFYING NUMBER OF ASSESSlNEtVT
lal lb) (d fdl lel
9ls3 12-31r60 6•25-5~ 6-28~400 !>-2~ 302.00
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PLACE OF FILI1VCa - - ~ .
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p~l'~e, ~01'~t~
WiTNESS my hand at ~Qr'~+ ~~'rid~t , on this,
the 16'~h ciay of _$rQt~~r ,19~_ •
DISTRIG7 DIRFCf:7~R Of IIYTEil~IArL REl/E7VUE 6Y (Signatu~s) TItIF
:P• S• ~'r~ . ~i7~lI~M ~Zt~+OAT
(IVOTE: CMifiaote of offics? outFarissd by law to tok~ wl~dq~nents is nct ~ssemial to the volidity o~ .R ti~p ol Tax C_M.
26419, C.0. 1950•51, i25.) 0 1~~" ~
PART 1-To b~ ntain~d by rMCOrding of~ic~ g4~~