HomeMy WebLinkAbout2965 Form 668 OE?ARIMEM Of ilE TREASURY-NiE~NAI S~VICE fa?Optiaw/ Us~ By Remrdin~ Ol/iet
tsEV. 2.i~1 NOTICE OF FEDERAL TAX LIEN UNDER INIERNAL REYENYE LAMR ~
DISTRICT J`a~W~~ SERIAL NUMBER ~.~u~t•
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£ = , T#{,Ax~
Purs~ant to~heprovisionsofSections6321,6322,and 6323 of the Interna) Revenue ~~~fi CQtt~K
Code; no~ice is hereby gi~en thot there havebsen auessed under the Internal Reve- ~'F~~~r
nua lows of the United Stoies against the followln~-named taxpayer, taxes (including ,
~~~erest orsd penol~ies) which ofter demond for payment thereof remain unpaid, and ~,H
rhot by virtue oftheabove-mentionedstafutestheomount of sald taxes, together wifh
penalties, interest, and costs that mayaccrueinaddNion therefo, k o lien in favor of
the United Stotesuponollprope~tyondrlghtsto property belonging to sold taxpayer.
NAME OF TAXPAYER
Jaw~ A i G~ett~ M Le+ritt
RESIDENCE
LaJNS1
• F! F3~eM. A 33450 `1r-----~ ~ -
UNPAtD BAtAN~E
KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT lDENTIFYING t1UMBER OF ASSESSnnENi
la) lbl I~~ ld) lel
~ ~-3~-?3 o6-t13-7~? 2&S-3~~ 778.2?
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~ W ITNESS my hand at on thls,
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~ SIGNATURE T{TLE
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~ (NOTEs C~rtifkot~ of oNk~r outhorii~d by bw b bk~ ocknowl~dym~nM k ~ol ~~s~nlbl to Ih• rolidihr of Notlu o( F~d~rol To: li~n G.C.M.
~ 46419. C.l. {9Sd51, 125.) -
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~ PART 1-To bt r~lain~d by r~cordin~ ofiic~ • e~QK~:J~ PACE~.r~1tJ~J
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