HomeMy WebLinkAbout97-05849
Form 868(Z)
(A....6\I!l
'1
Dlporlmont 0' the T....ury . Inlernol Revenue Servlcl
Certificate of Release of Federal Tax Lien
Dlllrlcl
Serial Number
For UBI b Racordln Olllce
~ F ~lt'I' t'I\}~\""l!~ " 1'1. J. .,;., i.1
I cartlly Ihat the 'ollowlng.named taxpayer, undar the raqulremenll 0' eectlon 8325 (aj
01 the Inlernal Revenue Code has laUlfled the tax.. lilted below and all statutory
addlUonl, Thorelore, the lIan provided by Code lecUon 8321 lor these taxea and
addition I h.. been relealed, The proper olllcer In the olflce where the notice 01
Intarnelr.venultexllenweallladCln I,. I "I.co, '.",' ,
~_ ,,_ t~: "'-~, II eulhorlzed to nole the book I to ahow Ihe relea.e 01 thle lien lor
these ta..a and addlllonl.
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Neme ollaxpsver
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Residence
S81 WILNUT E',OnOt~ Rfl
r::HrpPEf'I~::;P..IJP(~. PA t 72':.:7-9.:o:J
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(.rJUH 1 RFCOR [, n,G I Nf: DfIMA T J ON ~
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Tax Period Ended Identifying Number
(b) (e)
Sf~r' 1;1 I t'!.J.
~.:p .-~.F~4'~ FTL
Date 01 Laat Day lor
Aaae.ament Rellllng
(d) (e)
(.u:tl 1'1-:1131 1<# It'.n31
Kind 01 Tax
(a)
Unpaid Balance 01
A.....men!
(f)
1(14(1 L2"-3LI19'3S '~(l1l-'-3(1-6'3il~_~ flr~!t8.1tg(~} n'::~/t:'/2'HY? 35(HI.76
******* ***...h.'.' ****.******* ***..*..... .**......... .**********.*.*.
Plec. 01 FIling
Pt-'.'" h rJ rl(] l'. ::~,'\I
(IHuber" ~nd Count.v
Ci,,'1 ;" I p, PI\ 1'.7('J::J
Total
s
3500.76
This notice was prepared and signed at
~'lt.t'r,_ldn~l,h. pI\
, on this,
the
liht.h day of F(.t'~.ur"r-v.
.l~~'H
Signature /")! ". I Title 'I'I F', 'TI'
INOTE Ce,II,(",I'1I of orrinr iwlflOr/Ivrl by l.1w to I.1k1f aaUlawledgnents is not essonrlalto the validity of Certificate of RelfMse 0' Federal Tax lien Rev. Rul. 71-468, '971.2 CB. 409)
PART 1 . RECORDING OFFICE
Form 666 (V) (e) , i-I' O.pa.tmont of the Treasury. Internal Ruvenue Sorvlce
(Rev. Octo/Jer 19Q3i Notice of Federal Tax Lien
'District Serial Number For OpfJonal Us. by R.cordlnQ Ollie.
I {\II..;. (rl- 5 ii' J.n
. PEN~I'.>YLV!l.rll^, ;,....:11/ .J _1.'.".I.l FTL
1 A. provided by aectlons 632t, 6322, and 6323 of the Internal Revenue
! Cod., we all giving a notlc. that taxes (Including Interest and penalties)
! have been a.....ed agalnslthe followlng.named taxpayer, We have made
. demand for payment 01 this liability, but It remains unpaid, Therelore, , "
! th.1I Is 1 lien In lavor of th. United States on all property and rights to .,
, property belonging to this taxpayer for the amount 01 these taxes, and
, Iddltlonal p.naltles, Interest, and costs lhat may accrue,
,Name 01 Taxpayer ,
;!I\~I['.; W L>lJIH , .
, . .;
,Residence .. i
SOl WALNU r BO r rim R[I
..
. '':;HIPPEN:,BURG. PA J 12S7-';l604
IMPORTANT RELEASE INFORMATION: For each assessment listed below, 1,n L:D xl
I, I"
unless nolice 01 lien Is refiled by the date given in column (e). this notice shall, ~...).,A:-j ILl! '>U'?
on the day lollowlng such dale, operate as a certificate of release as defined
In IRC 6325(a), ~iIo S'7<n9
, Tax Period Date of Last Day for UnpaId Balanel
. Kind ofTax Ended Identifying Number Assessment Rellllng 01 A.....m.nt
, (8) (b) (c) (d) (8) (f)
,
, 1(41) 1~' I::H I~~S ~(14-.3(1-.6309 OB/18/97 09/17/07 3500.76
,
,
,
,
,
'Place 01 Filing
. P,'othorlOtal'Y
Total $
, Cumberland County 3500.76
, Carli.le, PA 17013
This notice was r'epared and signed at Pit:t.bllrqh. PA
, on this,
:the 27th day 01 Septernbe,', 19~,
1
:Slgnature
, fm' P. CR(JIO/;;.~/.J)';;._
Title
Revenue Of ficer' 23-,t) t -1455
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(NOTE: Clfllfleal. of ollle.r authorIzed by taw 10 lake a'eknowledgmlnts Is not 89unliilllo the vallriily of Nolle. of Federal TI. IIln ..
Rlv. Rul, 71.466, le71 .2 C,8, 40e) ...
Part 1 . Kept By Recording Ofllce Form 6ea (V) (c) (Rev, 10/9~' ~ ~