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Form 6b$ OfP~RTMENT OF THE TlEASURY-NTERNAI REVENUE SERVKE For Op~imol Use 8y Recor~~ng
(REV• t-701 NOTICE OF FEDERAL TAX l~N UND~ INTERNAI REVEI~11~ IAWS FILEO ANa AECORO~
DISTRICT SHtIAt NUMBER :t.lUC1E COUMTY F
J~ib~IIl~1~~ n~l•~ ROCER P011RAS
- - CIERK CIRCUIT C01tR~
Pu~iuant to the provisiorrs of Sections 6321, 6322, and 6323 of the Internol Reve- i1f.CORO VERIiIED~
nue Code, nohce is hereby given that there hwe been assessed under the Internu) t pu t
Reves,ue laws oE the United $tates aguinst the following-named taxpayer, taxes (includ- ~ e 1 OZ 1~1
ing interest and pen~lties) which aker demand for payment thereof remain unpaid. and
thct by vi~tue of the above-mentioned statutes the amount of scid taxes, together with
penaitEes, in?erest, and cosh lhat may accrue in oddition thereto, ~s o lien in favor of 225i36
the United States upon atl property and rights to prepery belonging to said toxpayer.
NAME OF TAXPAYER
slMfOi aod/•r tyati]~? ~
RESIDEN "E
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!t. T3+a~sy tl~rl~is
UNPAI~ 6ALANCE
KIND OF TAX TAX PERIOD ENDED ASSESSMENT DATE IDENTIFYING NUMBER OF ASSESSMENT
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" (NOTE: Certificate of o}Ficer autFarized by {aw to take «knowledgmenh is not atenlid to the volid"+ty of Notice of Federd Taz lien G.C.M.
26b 19, C.B. 1950-S1, 1~S.) ~0~~
PART 1-To b~ Mtaiwd blr rocordi~q o~lka
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