HomeMy WebLinkAbout07-5598Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien .n.. e .~_ s-~ q p FTL
Serial Number For Optional Use by Recordin Office
Area:
WAGE & INVESTMENT AREA #1 ,Pd
fJ, ,s Ir~g,w
Lien Unit Phone: (800) 829-7650 391572207 .
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As provided by section 6321, 6322, and 6323 of the Internal Revenue ~ ~ 7 ~ oy
Code, we are ;givin; a nodce drat taxes (includin; interest and penahies)
have been assessed asst the followin;-named taxpa)er. We have made ~, / ~ ~` ~ s q
a demand for Pay~t of this amity, bat it remains unpaid. Therefore,
there is a alien ~ favor. of the llnhed States on aN property and ri8hts to
property belontiin; to the taxpayer for the amoant of these taxes, and ~ ~'
additional pen ties, interest, and costs that may accrue. ~ ° ~r
~~
Name of Taxpayer ROBERT L KOIS JR z ~_;~;~,
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Residence
PO BOX 13 21 ~ ~, , ~ ~ y
MECHANICSBURG, PA 17055-1321 ~~-; ~~
IMPORTANT RELEASE 1NI:ORMATlON: 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 !RC 63251a).
Tax Period Date of Last DQa~yy for Unpaid Balance
Kind of Tax Ending Identifyfing Number Assessment Refiii»; of Aunt
a b c d e
1040 12/31/2002 XXX-XX-6552 09/04/2006 10/04/2016 8885.32
1040 12/31/2002 XXX-XX-6552 05/07/2007 06/06/2017
1040 12/31/2003 XXX-XX-6552 09/04/2006 10/04/2016 5095.41
1040 12/31/2004 XXX-XX-6552 04/30/2007 05/30/2017 5717.60
1040 12/31/2005 XXX-XX-6552 04/02/2007 05/02/2017 7455.52
1040 12/31/2006 XXX-XX-6552 05/21/2007 06/20/2017 5059.58
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 32213.43
This notice was prepared .and signed at
DETROIT., MI
the 14th day of September 2007
on this,
Signature ~ A \Yti1~~~~ Title
ACS 11-00-0000
for DEBRA K. BURST (800) 829-7650
(110TE: 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. 4091 Form 668(n(t) iRev. 2-2004)
Part f ' Kept ~ ~~ CAT. NO 80025X
Z
3
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11883 Department of the Treasury - Internal Revenue Service
Form 668 (Z)
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 391572207
I certify that the following-named taxpayer, under the requirements of section 6325 (a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on September 24
2007
, is authorized to note the books to show the release of this lien for
C G `-
these taxes and additions. T n
Name of Taxpayer mrr,
ROBERT L KOIS JR
Residence PO BOX 1321 ; C Nrn
MECHANICSBURG, PA 17055-1321
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
P`/ • A?
n/a n/a n/a 2007-05598 ?t '73L/
Tax Period Date of Last Da for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment RerLg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2002 XXX-XX-6552 09/04/2006 10/04/2016 8885.32
1040 12/31/2002 XXX-XX-6552 05/07/2007 06/06/2017
1040 12/31/2003 XXX-XX-6552 09/04/2006 10/04/2016 5095.41
1040 12/31/2004 XXX-XX-6552 04/30/2007 05/30/2017 5717.60
1040 12/31/2005 XXX-XX-6552 04/02/2007 05/02/2017 7455.52
1040 12/31/2006 XXX-XX-6552 05/21/2007 06/20/2017 5059.58
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ ?? 32213.43
This notice was prepared and signed at
the
18th day of August
Signature
fi.
DETROIT, MI
2010
, on this,
Title Director, Campus Compliance
Operations
I
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Part 1 - RECORDING OFFICE CAT. NO 600261