HomeMy WebLinkAbout09-1873Form 668 (Y)(c)
(Rev. February 20041
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~ 0 9- /,~ ~3 FTC
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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Lien Unit Phone: (800) 829-3903 524101509 .
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As provided by section 6321, 6322, and 6323 of the Internal Revenue 3 ~ `~ v
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Code, we are giving a nodce that taxes (h~cluding interest and penaltks) „
have been assessed against the follo~wing~named taxpayer. We have made ~ 1 J ~ ~ 3 7
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien M favor of the united States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
addhional penalties, interest, and costs that may aarue.
Name of Taxpayer THOMAS E BARD n rv
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Residence 18 BARD RD '`.- ~ r~~
SHIPPENSBURG, PA 17257-8143 f ' ' ,~~. _c
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IMPORTANT RELEASE II~IFORMATION: 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, -"'m
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on the day following such date, operate as a certificate of release as defined ~`
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in IRC 6325(a). ,~
Tax Period Date of Last Daar~rr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment ReflN ng of Assessment
(a b c d e
1040 12/31/2005 XXX-XX-1751 08/28/2006 09/27/2016 1022.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 1022 .75
This notice was prepared and signed at DETROIT, MI
the 12th day of March 2009
on this,
Signature ~ H ~YZi~~ ACS 22 - 0 0- 0 0 0 8
for MICHAEL W. COX (800) 829-3903
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(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. 2-2004)
PaR f ' ~Pt ~ ~~ ~~ CAT. NO 60025X