HomeMy WebLinkAbout04-1255Form 668 (Y)(c)
(Rev, February 2004)
1008
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (800) 829-3903 162626804
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
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
additional penalties, interest, and costs that may accrue.
X1,0. o v_ is ss FTL
For Optional Use by Recording Office
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j,, /49/y3
Name of Taxpayer JOSEPH T GEMBUSIA
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Residence 3510 RAINTREE LN
.v
MECHANICSBURG, PA 17055-2259
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, n? -
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a)•
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
6672 09/30/2001 173-36-8376 06/09/2003 07/09/2013 3635.45
6672 12/31/2001 173-36-8376 06/09/2003 07/09/2013 3116.10
6672 03/31/2002 173-36-8376 06/09/2003 07/09/2013 3635.45
6672 06/30/2002 173-36-8376 06/09/2003 07/09/2013 3116.10
Place of Filing
Prothonotary
Cumberland County Total $ 13503.10
Carlisle, PA 17013
This notice was prepared and signed at PHILADELPHIA, PA on this,
the 16th day of March 2004
Signs tu E") Title
/?q?`??;'???,'-{ 9yy??/ ACS 23-00-0008
for LEI7ER'" x' (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 668(Y)(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025X
Form 668 (Z) 2447 Department of the Treasury - Internal Revenue Service
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recordin g Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 162626804 ?GL
I certify that the following-named taxpayer, under the requirements of section 6325 (a) f?
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
?i ?53 S
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 :1
' a 3s !g
internal revenue tax lien was filed on March 24 ?
?• C)
c?
2004 is authorized to note the books to show the release of this lien for w Zfl
these taxes and additions. r
Name of Taxpayer % -c F
JOSEPH T GEMBUSIA co
Residence 3 510 RAINTREE LN a ., ?. M
MECHANICSBURG, PA 17055-2259 :J ro
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
n/a n/a n/a 04-1255 FTL V
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a (b) (c) (d e f
6672 09/30/2001 XXX-XX-8376 06/09/2003 07/09/2013 3635.45
6672 12/31/2001 XXX-XX-8376 06/09/2003 07/09/2013 3116.10
6672 03/31/2002 XXX-XX-8376 06/09/2003 07/09/2013 3635.45
6672 06/30/2002 XXX-XX-8376 06/09/2003 07/09/2013 3116.10
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 13503.10
This notice was prepared and signed at
the - 09th day of December
Signature
DETROIT, MI
2009
, on this,
Title Director, Campus Compliance
Operations
(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