HomeMy WebLinkAbout08-7056Form 668 (Y)(c)
(Rev. February 2004)
244
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~ h ~^ .~ M ~~ ~-,~-~
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050
496438808 y.~Q ~
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As provided by section 6321, 6322, and 6323 of the Internal Revenue C~ ;~ ~3 d.z~
Code, we are giving a notice that taxes (including interest and penalties
have been assessed against the following-named taxpayer. We have made ~, ~17~7~
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 ~" m
property belonging to this taxpayer for the amount of these taxes, and ~ ~ ~~
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additional penalties, interest, and costs that may accrue. -'_
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Name of Taxpayer KEVIN HOLLEY 1 -:- ~~
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Residence 2 5 ROBIN CT ?~' ~~-~ rv ~~ ~ ~~° ~
MECHANICSBURG, PA 17055-4372 -=w ~-
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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 63251a).
Kind of Tax Tax Period
EndMg
Identifying Number Date of
Assessment Last D for
Refi~ng Unpaid Balance
of Assessment
a) (b) (c (d) (e (f)
1040 12./31/2000 XXX-XX-8405 04/11/2005 05/11/2015 6460.10
1040 12/31/2004 XXX-XX-8405 05/23/2005 06/22/2015 3459.48
1040 12/31/2006 XXX-XX-8405 05/21/2007 06/20/2017
1040 12/31/2006 XXX-XX-8405 07/14/2008 08/13/2018 15811.81
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 25731.39
This notice was prepared and signed at
DETROIT, MI
the 21st day of November 2008
on this,
Signature ~ i~ ~~y~,~~,-~ REVENUE OFFICER 22 - 06 -1442
for DAVID M. SHROYER (717) 777-9625 x1320
_ ___
(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(ln(c) (Rev. 2-20041
Part 1 - Ktpc BY Recording Oltice CAT. NO 60025X