HomeMy WebLinkAbout03-0449Form 668 (Y)(c)
(Rev. October 2000)
499
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: I Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
lien Unit Phone: (412) 395-5265 230300504
As provided by section 6321, 6322, and 6323 of the Internal Revenm
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, 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 amount of these taxes, and
additional penalties, interest, and costs that may accrue.
For Optional Use by Recording Office
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NameofTaxpayerMELRETTA C SIMPSON
MELRETTA'S COMMERCIAL SERVICE
Residence 914 SPRING CIRCLE
MECHANICSBURG, PA 17055
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the 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).
Kind of Tax
(a)
940
941
941
941
941
941
Place of Filing
Tax Period
Ending
(b)
12/31/2001
03/31/2000
09/30/2001
12/31/2001
03/31/2002
06/30/2002
Identifying Number
(c)
23-2624434
23-2624434
23-2624434
23-2624434
23-2624434
23-2624434
Date of
Assessment
(d)
10/07/2002
08/19/2002
08/19/2002
10/07/2002
08/26/2002
09/30/2002
Last Day for
Refiling
(e)
11/06/2012
09/18/2012
09/18/2012
11/06/2012
09/25/2012
10/30/2012
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
Unpaid Balance
of Assessment
(f)
752.64
8131.08
5853.14
6642.78
3562.14
1508.64
26450.42
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the 23rd dayof January 2003
Signature Title
· ~ , ,- ,_,~ - -- ~ -- ./'~7/~ ~' ~, REVENUE OFFICER 23-11-1441
for
(NOTE: Certificate of'"~oer authorized by law to ta~cknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409)
Part I - Kept By Recording Office Form 668(Y)(c) (Rev. 10-00)
CAT. NO 60025X