HomeMy WebLinkAbout03-0757Form 668 (Y)(c)
(Rev. October 2000)
2941
Area: J Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA
lien Unit Phone: (412) 395-5265 230301345
As provided by section 6321, 6322, and 63Z3 of the Internal Revenue
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 proper~ and rights to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JAYNE A EVANS
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien 7~. ~ 3- ?.Y;7 F' T/-
For Optional Use by Recording Office
Residence 3515 BEECH RUN LN
MECHANICSBURG, PA 17050-2207
Kind of Tax Tax Period Date of Last Day for Unpaid Balance
Ending Identifying Number Assessment Retiring of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2001 167-58 5823 02/18/2002 03/19/2012 622O. 37
Place of Filing
Prothonotary
Cumberland County Total
Carlisle, PA 17013 6220.37
This notice was prepared and signed at
the 04th day of February
PITTSBURGH, PA
2003
, on this,
Signature~.~. /~~~~ ~'~ Title
ACS z -oo-oooo
for P
~:' ~trtificate °' °'"ce' auth°rized bY law '° tak~ ackn°wledgmerit is ot essential ,o the validity of Notice of Federal Tax lien . uL /1-466, 1971 - 2 C.B. 409)
Pa~ 1 - Kep¢ By R~ordin~ O~ce Form 668(Y)(c) (Rev. 10-00)
CAT. NO 60025X