HomeMy WebLinkAbout97-00958
Fonn 668 (Z)
IR.v. 10-20001
1008
Deportment of the Treesury , Internal Revenue Servico
Certificate of Release of Federal Tax Lien
Aree: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA "3
Lien Unit Phone: (412) 395-5265 239710950
For Use b Recordin Olllce
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I cartlfy that th. lollowlng.n.mod taxp.y.r, unde, tho requir.ment. of .oction 6325 101
0' tho Int.rnal Revenue Cod. h.. ..tilfied the tax.. Ii.ted below and all st.tutory
additions. Th.r.to,a, tho li.n provid.d by Cod. soction 6321 for thes. t.xos .nd
additions haa bo.n '.I..I.d. Th. prop.r officer in tho office where tho notic. of
intarnal r.v.nu. t.x lian w.s fil.d on February 24
1997 . il outho,iz.d to note tho boakl to Ihaw tho r.la..e of this lien for
th.l. t.X.I .nd addition..
Nome of Taxpayer
KENNETH & JOYCE JORRITSMA
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Residence PO BOX 457
NEW KINGSTOWN, PA 17072
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COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
n/a n/a n/a 97-958 FTL
Tax Period Date of
Kind of Tax Ending Idenllfylng Number Assessment
(sJ (bJ teJ (dJ
1040 12/31/1993 031-38-1237 11/11/1996
1040 12/31/1994 031-38-1237 11/11/1996
1040 12/31/1995 031-38-1237 11/25/1996
******** ********** ************* **********
wt Day for
Renllng
(eJ
12/11/2006
12/11/2006
12/25/2006
***********.
Unpaid Balance
of Assessmenc
(fJ
4908.08
8056.72
6180.15
************.***
Place 01 Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Tolal $
19144.95
This notice was prepared and signed at
Philadelphia, PA
,on Ihls,
the
05th day 01 November
2003
Signat~
(t) MVi!.t..~
C6-f2'
Title Compliance Technical Support
Manager
;2,.
(NOTE: Certificato of officer authorizod bV law to take acknowlodgments is not ossential to the validity of CertUicato of Aelease 0'
Foderal TOlC lien Rov. Au!, 71.466,1971.2 C.B. 409)
Pan I . RECORDING OFFICE
Form 668 (Z) (Rov, 10-20001
CAT. NO 600261
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Dlpartmenl of lhl Treasury - Internal Rlvlnue Service
Form 668 (V) (c)
(Rev. October 1993)
District
Notice of Federal Tax Lien
Serial Number
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AI provided by lectlons 6321, 6322, and 6323 of the Intarnal Revenue
Code, wa are giving a notice that taxas (Including Interest and penalties)
have been asselsed against tha following-named taxpayer. We have nlade
a demand for payment of thll liability, but It remains unpaid. Therefore,
there II a lien In favor of the United States on all property and rights to
property belonglnil to this taxpayer for the amount of these taxes, and
additional penaltlel, Intarest, and costs that may accrue.
Name of Taxpayer f P.,;.lt I', ,; 1(," ,! 'I'" I" ,",:.
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notlca of lien Is refiled by the date given In column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
In IRC 6325(a).
Tax Period
Ended
(b)
Residence
,i I I.;.'I( .
!.p- II. ' . I-j.:;'__, i '.il,.r'
Kind otTax
(a)
Date of
Assessment
(d)
Idantlfylng Number
(c)
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This notice was prepared and signed at
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For apI/one/ Use by Recording Olllce
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Last Day for Unpaid Balance
Reflllng of Assassment
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Total $
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, on this,
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Signature f(J~~. trl,~~,;:c I Title :. " ". ".
(NOTE: Cerllfleat. 01 ollleer aulhorlzod by law 10 take aeknowladgmanllll not ...anll.1 to thl validity 01 NoUel 01 Faderal Tax IIln
Rlv. Rul. 71.466, 1971 .2 C,B, 409)
Part 1 . Kept By Recording Olllco
Form 668 (V) (c) (Rev. 10/93)
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