HomeMy WebLinkAbout08-1566Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~ n ~ _ ~ SL 4 r r~
A Serial Number For Optional Use by Recording Office
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WAGE & INVESTMENT AREA #1 ~J~ p
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Lien Unit Phone: (800) 829-7650 425339008 ~
As provided by section 6321, 6322, and 6323 of the Internal Revenue Gt. is 7~z~
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 ~ z b ~ g' 7
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 ~ Q
additional penalties, interest, and costs that may accrue. -~, ~ ~ ~
Name of Taxpayer ROBERT A KOZENSKIE 4-;'.-:
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Residence p0 BOX 53
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ENOLA , PA 17 0 2 5 - 0 0 5 3 ~, = ~'
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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 (et, 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 Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) b) (c) (d) (e) (~
1040 12/31/2003 XXX-XX-8910 06/14/2004 07/14/2014 1359.68
1040 12/31/2004 XXX-XX-8910 05/16/2005 06/15/2015 1543.45
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 2 9 0 3.13
This notice was prepared and signed at
the 28th day of February
DETROIT, MI
2008
on this,
Signature ~ ~ \Y21~~ Title
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. 4091 Form 668(lt7(c) (Rev. 2-20041
Part 1 -Kept BY Recording Office CAT. NO 60025X