HomeMy WebLinkAbout07-3678Form 668 (Y)(c)
(Rev. February 2004)
71
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien .y~ a ,~ 3~ .~ ~ r_ r~
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1
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Lien Unit Phone: (800) 829-7650 370558507
As provided by section 6321, 6322, and 6323 of the Internal Revenue ~ ~~ 71
Code, we are giving a notice that taxes (including interest and penalties) ~
have been assessed against the following-named taxpayer. We have made ~ I 4ya 9s
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 .--f''~ c.~ T
additional penalties, interest, and costs that may accrue. ~ 9~ rr~
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Name of Taxpayer TOM CABA a -
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Residence 841 OLD FORGE RD .; ~-{ ~'-`
NEW CUMBERLND, PA 17070-2529 ~ c..~
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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).
Tax Period Date of Last D for lJnpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi~ng of Assessment
(a) (b) (c) (d) (e) (f
1040 12/31/2002 XXX-XX-3796 08/08/2005 09/07/2015 8892.28
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA-17013
Total ~$ 8892.28
This notice was prepared and signed at DETROIT, MI
the 12th day of June 2007
on this,
Signature y ~~y~,~,,~QQ ACS 11-00-0000
for DEBRA K. HURST (800) 829-7650
(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)
Part t -Kept By Recording Office Form 668(Y)(c) (Rev. 2-20041
CAT. NO 60025X