HomeMy WebLinkAbout1891 r
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Form 668 ~ Department of the Treasury -Internal Revenue Service
;Rev. Septembert978l~ Notice of Federal Tax Lien Under Internal Revenue Laws
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Distract !Serial Number For Opt+ona/ Use Dy Racdd~ng Ofl+te
Cincinnati-Colt,mtbus, Ohio ~ 60115 4~~
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As provided by sections 6321, 6322, and 6323 of the Internal Revenue Code,;
notice is given that taxes tincluding interest and penalties) have been assessed
against the following-named taxpayer- Demand for payment of this liability has
been made, but it remains unpaid. Therefore, there is a lien in favor of the United
States on all property and rights to property belonging to this taxpayer for the Fllt:~ • ='+(~EO
iT. LUrl~ v' r FIA.
amount of these taxes, and additional penalties, interest, and costs that may ~ •
aCCfue_ Cl L ° r. L llRT n
tJame of Taxpayer ~c ~ ~ PM ' `
Robert A Gill M D ~ rl
Residence 4 4~~1
3158 E. Broad St., Colt,aabus, Ohio 43209 ~ ~
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Unpaid Balance
Kind of Tax ~ Tax Period Ended , Oate of Assessment Identifying Number of Assessment
(a) ~ (bl I lc) (dJ (e)
941 3.31-78 ~ 12-18-78 31-0681850 2,740.50
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941 6-30-78 9-4-78 31-0681850 61.21
941 9-30-78 12-18-78 31.0681850 607.84
941 12-31-78 12-03-79 31-0681850 2,837.21
941 3-31-79 6-11-79 31-0681850 2,014.67
941 6-30-79 9-24-79 31-U681850 1,876.67
940 12-31-77 3-27-78 31-0681850 113.82 _
4 940 12-31-78 ~ 11-05-79 31-1)681850 57.17
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' Place of Filing
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f Total ~ i 10, 309.09
3t. Iucy County Court Recorder i
This notice was prepared and signed at Coha:!ubus, Ohio , on this.
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the - 51:h day ofDecenber , t g 79
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Sign lure i Title
~ ~ ` Revenue Officer (Group 23)
(NOte: Cert~/+cate o/ oif+c r auihor~red by taw to taxo acknowledgments es nor essent+al to the val+drty o/ Notice of
Fed.ral Tar l~sn 6 C.IN- 26419. 1950 / C. B 175 1