HomeMy WebLinkAbout08-6198Form 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 ,P~ ~ s~q,lh~
Lien Unit Phone: (800) 829-3903 480020408 ~
As proviided by section 6321, 6322, and 6323 of the Internal Revenue ~ ~ ~, v5(,
Code, we are giving a notice that taxes (including interest and penahies)
have been assessed against the following-named taxpayer. We have made ~ ~ /G d 3G
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
additbnal penalties, interest, and costs that may accrue. ~ c O
-~ ° -n
Name of Taxpayer JEREMY W & DOREEN M HELM -~~~ ~,
. rs't
Residence 3520 BEECH RUN LN ,
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MECHANICSBURG, PA 17050-2206 ~;.~ 3 j
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
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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 ppa~yy for Unpaid Balance
Kind of Tax Ending ldentifj-ing Number Assessment ReBflng of Assessment
(a b) c d e
1040 12/31/2004 XXX-XX-3457 10/23/2006 11/22/2016 6024.83,_.
1040 12/31/2005 XXX-XX-3457 10/02/2006 11/01/2016 9028.52
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 15 0 5 3 .3 5
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This notice was prepared and signed at DETROIT, MI
the 07th day of October 2008
on this, .
Signature ~ A \Y2~~~~ 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. Rui. 71-466, 1971 - 2 C.B. 409)
Pant _ ~t ~ Rlcord~aE OlRc~ Form 668(lf7(c) IRev. 2-20041
CAT. NO 60025X