HomeMy WebLinkAbout08-7055 2447
Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice Of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREP, #2 ~ ~~~ ~
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Lien Unit Phone: (800) 829-3903 495914908 •
As provided by section 6321, 6322, and 6323 of the Internal Revenue e-k. aP-~~'i
Code, we are ghring a notice that taxes (including interest and penalties)
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have been assessed against the following-named taxpayer. We have made ~ -~ ~ 7
a demand for payment of this liability, but it remahtls 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
addkional penalties, interest, and costs that may accrue. ~,
Name of Taxpayer TYSON L SYBRANDT
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Residence 1004 COUNTRY CLUB RD L
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CAMP HILL, PA 17011-1048 --;~ ~ r~
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, - ~`~ ~a ~ ~
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 6325(a).
Tax Period Date of Last Daayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Re8ling of Assessment
(a b c d (e
1040 12/31/2004 XXX-XX-6656 09/19/2005 10/19/2015 711.94
1040 12/31/2005 XXX-XX-6656 11/20/2006 12/20/2016 295.90
1040 12/31/2006 XXX-XX-6656 11/19/2007 12/19/2017 651.18
1040 12/31/2007 XXX-XX-6656 06/23/2008 07/23/2018 3408.86
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 5067.88
This notice was prepared and signed at
DETROIT, MI
the 20th day of November 2008
on this,
Signature ~ A ~>'i~,7.cl~ 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 By Ruording Office Form 668(lf)(c) (Rev. 2-2004)
CAT. NO 60025X