HomeMy WebLinkAbout97-00947
Department olthe Treasury. Internal Revenua Sarvlce
Form 668 (V) (c) Notice of Foderal Tax Lien
(Rev, October 1993)
District Serial Number For Opl/onal Use by R.cordlng Olflc.
, , .. , Nu. Ch-9-n FTL
As provided by secllons 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a nollce that taxes (Including Interest and penallles)
have been assessed against the followlng.named taxpayer. We have made (") .0 0
. demend for payment of this liability, but It remains unpaid. Therefore, ~:: _J -"
! there Is a lien In favor of the United States on all property and rights to -., 'J
"'t"Ii',' ", ,:n
, property belonging to this texpayer for the amount of these taxes, and fli' , ~,
hi
0'.- .
I eddlllonal penallles, Intarest, and costs thet may accrue, , ' >) ':6
IName of Taxpayer (I:'. - ')
" , ' , , r:.: \. .--::J !~
I ',-
,', -- .. )
. j"11
1 .' " ~?
-,
I Residence " :n ".
" .. '0
.. 0 :.::
I ,\";i. '>0.1 ,
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless nollce of lien Is refiled by the date given in column (e), this notice shall. .'11 q LX> l>d
on the day following such date, operate as a certificate of release as defined <........rl 133'~%'
In IRC 6325(a). A>4 /.. ~I?'<;'l
,
I Tax Period Date of Last Day for Unpaid Balance
j Kind ofTax Ended Idenllfylng Number Assessment Reflllng of Assessment
I (a) (b) (c) (d) (e) (f)
i 1\,,;; " ,C ~ .:. ."5 - '''1- : " " , ' ; ~ t ! . ..
i - -
.
I
I
I
j
!
!
I
i
!
,
,
:
I
,
Place of Filing
, " Total $
:1 ' , - ~ ~ ' 1 i 11..,
.. "
This notice was prepared and signed at
, on this,
the
"
day of
.19_,
Slg","" W.iP<.. m ~~ Till. ., ...
(NOTE: C"lIllc.l. 01 olllelr .Ulhollzed by law 10 lakl aeknowl.dgm.nlll. nol ....nllallo Ih. validity 01 Nollel 01 Fld.r.' Tax Illn
R.v, Ru!. "-466, '971.2 c,e, 409)
Part 1 . KepI By Recording Office Form 668 (V) (e) (Rev. 10/93)
r
r.
,..
...
(~. ,
...
.
.
.
.
.
..
'.,
...
...
.... I
'.,.1
, i
\",J
....,
--*--
1008
Depertment of the Treesury - Internel Revenue Service
Certificate of Release of Federal Tax Lien I
Form 668 (Z)
IRev. 1().20001
Aree: Seriol Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 239719488
For Use b Recordin Office
111 ;J'If' '.!J" tV
I cortify thot tho lollowing,nomod toxpayor, undor tha roquiremonts of section 6325 (a) C/G. II~
01 tho Internal Rovenue Code has setisfied the taxes listed below and ell stetutory
edditions, Therefore, the lion provided by Code section 6321 for these texes and Rv-.lf-'51,!
edditlons hes been released, The proper officer in the office where the notice of
internal revenue tex lien was Ii led on February 24
1997 ,is authorized to note the books to show the release of this lien lor
these texes end edditions,
Neme 01 Taxpayer
DAVID A CLOUSER
, " r-_'
I , '--)
,. . '1
"- .
( - ..j
", ..
" j
I 'i
" " , 1':',
L I .' 0-
: ,
;
, ,
'-
\.C ,
Residence 41 0 0 CHURCH ST
CAMPHILL, PA 17011-4222
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
n/a n/a n/a 97-947 FTL
Tax Period Date of Last Dar. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Rem ng of Assessment
(/JJ (bJ (eJ (dJ (eJ (fJ
1040 12/31/1995 168-48-4842 09/23/1996 10/23/2006 8411. 05
******** ********** ************* ********** ************ ****************
Place 01 Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
8411.05
This notice was prepared and signed at
Philadelphia, PA
, on this.
the
14th day 01 July
2004
... c (.
/,',! .,,...- '-,
~""/:""l...:~lj:J
f:'
I
Title Compliance Technical Support
Manager
('> 0'-1
~;"(.;;;;(l,1 .I
(NOTE: Certiticale of ofllcer .1uthulIlOd by law to lake acknowledgments is not essential to tho validity 01 Cerlificate 0' Release of
Federal Tall hen Rev. Rul. 71 466. 1971 .2 ca. 4091
p.n I . RECORDING OFFICE
Form 668 (Z) IRov, 10,20001
CAT NO 60026\