HomeMy WebLinkAbout08-5158Form 668 (Y)(c)
(Rev. February 2004)
152
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~~~ - G ~ - S s`Fr ~T L
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #1 4~9,~G ~Q
Lien Unit Phone: (800) 913-6050 465138308
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As provided by section 6321, 6322, and 6323 of the Internal Revenue c
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Code, we are giving a notice that taxes (including interest and penakies)
have been assessed against the folloMring-named taxpayer. We have made .
a demaf>td for payment of thk liability, but k remah~t unpaid. Therefore,
there is a lien in favor of the lJnited States on all property and rights to ~ ~ ~
property belonging
to this taxpayer for the amount of these taxes, and ~, `"~ °' -"
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addkional penaltks, interest, and costs that may accrue. r'~' ~~ '
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Name of Taxpayer ROY R DESGROSEILLIERS ~ r N ~"°-'~'
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Residence
122 SOUTH SECOND ST APT 2 ;,
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WORMLEYSBURG, PA 17043 y
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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 8325(a).
Tax Period Date of Last ppa~yy for Unpaid Balance
Kind of Tax Endhtg IdentifyMg Number Assessment Reflling of Assessment
a b c) d e)
1040 12/31/2006 XXX-XX-3489 11/27/2007 12/27/2017 29957.10
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 29957.10
This notice was prepared and signed at DETROIT, MI
the 18th day of August 2008
on this,
Signature ~ i~ J~~~~ Title
CASE PROC MGR 21-00-0018
for PEGGY D'AMICO (866) 611-6191
(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 668(n(c) (Rev. 2-2004)
Part 1 -Kept fiy Recordins Office CAT. NO 60025X