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- 466503
Form 668 Department of the Treasury -Internal Revenue Service
(Rev. Seluemtrer1978) Notice of Federal Tax Lien Under Internal Revenue Laws
District Serial Number For Optional Use try Recording Office
lc:~omr~.? 'SZ9 NO'S 19 3= 39
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As provided by sections 6321. 6322. and 6323 of the Internal Revenue Code, FILEU AhC )'_t:U~Jt :1
ST.ll;t:)E GO~NTY.FIA.
notice Is given that taxes (including interest and penalties) have been assessed ROG~R PC)TRtiS
against the following-named taxpayer. Demand for payment of this liability has Ct-ERtS CtRCUtT tGttR/TD
been made, but it remains unpaid. Therefore. there is a lien in favor of the United ~E~Crtt v)~!'~r~s
States on all property and rights to property belonging to this taxpayer for the ~ j
amount of these taxes, and additional penalties, interest. and costs that may ~~~03
accrue.
Name of Taxpayer _
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Residence
11 :rd Wit.
Unpaid Balance
IUnd of Tax Tax Period Ended Date of Assessment IdentNying Number of Assessment
leI lDI . lcI ld) ls)
91+1 vir-3 .r.~, , J~- - ~ ~ ~ ~ , _ ,
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Place of Filing
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~J .a ~1_rC.yi V Vl~~~rll
'_JV• _lr lni ilv.w.. J,~T J~J..r Vi...+.../~~ Total : .z /
This notice was prepared and signed at =
~ • = - ~ , on this,
the 31t day of ~-cue,. ~1S 7~;-.
Signature Title
an~x320 PAGEi~
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(NWe: Certificate o? sufhorized by to fake acknowledgments Js not euentia/ ro the validity of Nonce o/
Federal Ta,: lien o.c. lg, lsasar, c.s. s.)
`Part 1 =1To be kept by recordirp office Fam 668 (Rev. 9.78)
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