HomeMy WebLinkAbout07-4054Form bb8 (Y)(c)
iRev. February 2004)
4805
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~ ~ n ,, _ ~a sY ~~r~
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
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have been assessed against the
following-named taxpayer. We have made ~ ~ ~
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a demand for payment of this liability, but it remains unpaid. Therefore, r~ / 9 y y 99 ; ~`~ ~
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there is a lien in favor of the United States on ati property and rights to -
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property belonging to this taxpayer for the amount of these taxes, and j`;: u1 ;_~
add>ttional penakies, interest, and costs that may accrue. {
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Name of Taxpayer HEALTH MED ONE INC ~~ ~ ~rn
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Residence 3 617B S IMPSON FERRY RD ~
CAMP HILL, PA 17011-6407
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 Dar~rr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) b) (c) (d) (e)
CIVP 12/31/2003 25-1752752 10/16/2006 11/15/2016 10200.00
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 10200.00
This notice was prepared and signed at
the 31st day of May
DETROIT, MI
2007
on this,
Signature ~ A \Y~2~~~ ACS 22-00-0008
for REGINA OWENS (800) 829-3903
(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) Form bb8(X)(t) (Rev. 2-2004)
Part t -Kept 8Y Recording Office CAT. NO 60025X