HomeMy WebLinkAbout09-1872Form 668 (Y)(c)
(Rev. February 20041
4805
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~ ~ 9 ~ ~ ~ F" T z
Area: Serial Number For Optional Use by Recordin office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Li
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en Unit Phone: (800) 829-3903 524081909 •
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As provided by section 6321, 6322, and 6323 of the I~rternal Revenue
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Code, we are givin8 a Waite that taxes (including interest and penaltks) '
have been assessed a~nat the fo[bwvin8-nallned taxpayer. We have made ~, ? ~ ,~ ~ 3 4
a demand for payment of this liability, but k remains unpaid. Therefore,
there is a lien in favor of the United States on all property and ri8hts to
property belong to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may aurae. _
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Name of Taxpayer JEREMY W & DOREEN M HELM ~ ~
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Residence
3 52 0 BEECH RUN LN `- ~
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MECHANICSBURG, PA 17050-2206 ,
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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 le?, this notice shall, :^• ~~~-:
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on the day following such date, operate as a certificate of release as defined c~ -<
in IRC 13325(a).
Tax Perbd Date of Last D~ay for v~aid B~ance
Kind of Tax Endh~ Identifying Number Assessment Refi ~g of Assesatnettt
a b c d (e
1040 12/31/2007 XXX-XX-3457 11/24/2008 12/24/2018 21568.32
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 21568.32
This notice was prepared and signed at DETROIT, MI , on this,
the 12th day of March 2009
Signature ~ ~ ~~Z~~~;~ 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) Form 668(lf)(c) (Rev. 2-2004)
Part 1 -Kept Bp RetordinE Office CAT. NO 60025X