HomeMy WebLinkAbout04-1633Form 668 (¥)(c)
{Rev. February 2004)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA ~3
Lien Unit Phone: (412) 395-5265 165555304
As provided by section 632i, 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.
Name of Taxpayer SCULPTURED IMAGES INC , a Corporation
Residence
1008
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
0 ~/-/u:~ FTL
For Optional Use by Recording Office
ck- 7~s/
204 S FRONT ST
WORMLEYSBURG, PA 17043-1335
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 da,/ 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 Retiring of Assessment
(a) (b) (c) (d) (e) (f)
941 12/31/2001 25-1742254 03/15/2004 04/14/2014 13538.04
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 13538.04
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 31st day of March 2004
at~ Title
forr/c x 221- 4 0
(No'rE: 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)
Pan 1 - Kept ~ ~ordlng O~ce
CAT. NO 6002~X