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-~orm 668 OEPACfMENT OF TF# TRE/WM~'f-INTERNAL tEVFNUE SERViCE Fo. Oporal Use sy Rao.d~g OlSc~
+REV. ~.~e~ NOTKE Of FEDERAL TAX UEN UMDER MITNtNAI REVENUE tAWS
~JiSTRiCT SERIAL NUMBER l~1LE0 AND RECORO~D1
T.`W~oR~ vEaT~ E~~~
Pursuont to the provisions of Sections 6321, 6322, and 6343 of the Interrtal Reve- ~~(~'~`3
nue Code, notice is hereby given that there hme been assessed under the Internat ! ~
Revenue taws of the Un~ted States against the following-nomed tozpoyer. taxes (includ- Af~~ ~ t~~9
ing interest and penaltiesj which after demond for poyment thereof remain unpaid. ond ~~L
thot i~y v~rtue of the obovementioned statutes the omount of wid taxes, toge~her with
penalties, interest, and cosls that moy occrue in add~tion thereto, is o fien in favor of fi~~E~ ~01 AS
the United States upon oll property and rights to properfy belonging to said toxpoyer_ CLE~K C'RCUi7 CDUR7~
NAME OF TAXPAYER
H~q~~ L. ~~rd0~
RESIDENCE
P. 0. Boz 1586
l~~t Pi~re~ !'u?rl~?
UNPAID BAUNCE
KIND OF 7AX T/1X PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
lal t~l t~! ldl l~l
! lpi~0 12•31r•6T 5-1~ ~ 33~b ~39.71~
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~ ~0 12-33~-6+9 ~ ~~-~333b 200.51~
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~+~ACE OF FILING Cj~~~ ~S (~,~t
' $L• Li01~ C~ TOTAL s 6~'~
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~ WITNESS n+r hond or i~fist ~ai~ H~+~ah~, ~'L0~l1+d~ , on thi:,
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(NOTE: Cert~ficab d ofl'ic~r arthoriud br law io tok~ ocknowled~m~nb is not a»n?id b IF~ vol~~r oi Notia d F~d Tox li~n G.C.M.
~ 2M19, C.B. 19S0-S1, 125.)
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PART 1-?o b~ rMain~d b~? ncordirp o18c~
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