HomeMy WebLinkAbout08-4815Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
460944208 O~ - a~~ ~~
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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
a demand for payment of this liability, but it remains unpaid. Therefore, ~, ~ ~3 2
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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
additional penalties, interest, and costs that may accrue. ~~- ~ ~ 2 q (s
Name of Taxpayer JESE D SAPHORE
Residence 4 94 GLENN ST # A
MECHANICSBURG, PA 17055-4137
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 63251a1.
Tax Period Date of Last Daayy for unpaid Balance
Kind of Tax Ending Identifying Number Assessment R e8ling of Assessment
a) (b c (d (e)
1040 12/31/2002 XXX-XX-4953 04/09/2007 05/09/2017 2539.01
1040 12/31/2003 XXX-XX-4953 04/09/2007 05/ 09/2017 4627.57
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 7166.58
This notice was prepared and signed at
the 01st day of August
DETROIT, MI
2008
on this,
Signature ~ ~ ~Y~~~ Title
ACS 22-00-0008
for MICHAEL W. COX (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)
Part 1 -Kept iity Re[ordin~ Office Form 668(ln(c) IRev. 2-2004)
CAT. NO 60025X