HomeMy WebLinkAbout03-2320Form 668 (Y)(c)
(Rev. October 2000)
1008
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien 7~. 0 3 · .2 ~ ~-~
FTL
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #3
lien Unit Phone: (800) 829-3903
Serial Number
106959003
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 CaxpayeF. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United S~ates on all pFoperty and rights tO
property belonCng to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer KAREN SMITH
Residence
530 JOYCE RD
CAMP HILL, PA 17011-2042
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).
For Optional Use by Recording Office
Kind of Tax
(a)
1040
1040
Place of Filing
Tax Period
Ending
(h)
12/31/1995
12/31/1996
Identifying Number
(c)
203-42-4555
203-42-4555
Date of
Assessment
(d)
08/09/1999
08/09/1999
Last Day for
Refiling
(e)
09/08/2009
09/08/2009
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
Unpaid Balance
of Assessment
(f)
19867.79
3487.73
23355.52
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 06th dayof May , 2003
Signat ' Title
ACS 23-00-0008
for - (800) 829-3903
(~IOT£: 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)
Part I - Kept By Recording Office Form 668(Y)(c) (Rev. 10-00J
CATo NO 60025X