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Irs Delivary June 24 Img - 20190624 - 0003
Irs Delivary June 24 Img - 20190624 - 0003
Irs Delivary June 24 Img - 20190624 - 0003
if. Novernlerzor4
) Go to www"irs.govfForn5d for instructiEns and the talest inferrnation.
oMB t{o. 1545-S,3
Dep#trnent of the freas.ry
lntsnal Revmue Seryice $*tcrn*l Sl€verue €ode s€c*io*s ffi36 and 63*3)
IEEil Hentification
il=nE *p*rsan? Secadsrt's s€crEitl Eo.
DARRI$ YOUHG, Federal***stee and "Pullic Qfice"
persfifl for whilfir you are e*ting {aumber, street, erd room ar s*ite no.
11'lf c*nstitrrti*n Avenue,$!.!4r{dcrsicite of "Pubjic office "Pursuant to Fed -F. civ. p. r7{b}}
City artowfi, *ate, addrcss, see imtructions.)
l{ashing(en, Districl cf Col*mbia 302tt*;" Uniled SHtes" Distric{ af f,olumhi* As E=*n* in 26 USC FI01 {a}and {g},{{G}
Frducrary's r.rame
Judge James ll( Lamnrey, Adminisfative Ofice of tfie Courts, Clerk ot lhe Criminal Court
ofiduciary {*umbsr, s!r+et" aad roorn or suhe no.}
Address
20'l Poplar Avenue, Suite 519
Ciiy cr tas.!, stat€, alrd AP code
F{emphis,TFl 3St{13
Sectian A. Autharity
A*therity fcr fiduciary relaticnsf:ip. Cl"ieek appli*able box:
a fl ecurt appointme*t *f testate estate {valid willexistsi
b tl Cai*rt appcintrnent sf intestate estate {n<: valid will exists}
e [J f"curt appcintmer$ *s guardian or csnservator
d f Valid trust instrurnent a*d amendrn*nts
€ f Bankru:picy or assignrnent for th* beaefit or ereditors
I
If your authcrity as a fidueiary does not cayer all years or tax periods, ch*k here > fI
and tist ttrc spific years or p"riads >
For Papsrwork Ftadqciian A*t and Frivafry Act Ha,tics, s€€ *+parale instruciicns, Cat. Na.1s3751 fann56{fiev- 11-2C17J
iuN 2 4 2019
Signature
I ceftil!" that I nave tlp auihorrty to Ex;cuie this notice concerning frducjary reiaticns';p on Oehaif of the taxsayer
Please
Sign dY;fihffC-" ff'?"' l;;s b ft,)fN;+
Here JUDGE JA'*=S M- LAT$*'=Y
Itie. if appticabfe
Form$S(Bev 11-2017i