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HomeMy WebLinkAbout07-1718 3355 Form 668 (Y)(C) (Rev. February 2004) Department of the Treasury - Internal Revenue Service Notice of Federal Tax Lien 1Lc. 61. /7Jf? C-rL Area: Serial Number SMALL BUSINESS/SELF EMPLOYED AREA #2 Lien Unit Phone: (800) 913-6050 352469307 As provided by section 6321, 6322, and 6323 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 property 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 KENNETH R ROUSH For Optional Use by Recording Office /J... p -11 /I / 4, \It) CJt.,. /S (, 06 Ru. I ~o;lt., Residence 14 PARADISE DR CARLISLE, PA 17015-9725 r-.' '-- 2:'~ ~ ~ <=:) 0 <:::::> -.. "'T1 :x -t > :1:.." ::0 I'ni=' N -Of"Tl -~)O W :~-::..... i :::1(:) :2> r+:B -~ :j. C) -'"'" - ,3m - .. .-1 0 ~ 0> -< (") C" ;Z? :g,US ~f:' cr, I 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 IRe 6325(a). Tax Period Date of Last D~ for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refi ng of Assessment (a) (b) (c) (d) (e) (0 1040 12/31/2002 XXX-XX-9812 08/22/2005 09/21/2015 46546.69 1040 12/31/2003 XXX-XX-9812 10/23/2006 11/22/2016 75182.84 1040 12/31/2004 XXX-XX-9812 10/23/2006 11/22/2016 75952.37 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total $ 197681.90 This notice was prepared and signed at DETROIT, MI , on this, the 20th day of March 2007 Signature Title REVENUE OFFICER (717) 777-9623 x1300 22-06-1450 for JEFFREY WHITE (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev. Rul. 71-466.1971 - 2 C.B. 409) Pan 1 . Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004) CAT. NO 60025X