HomeMy WebLinkAbout09-1971Form 668 (Y)(c)
(Rev. February 2004)
4805
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
LienLUnB PhoneSS800) F913P6050D ~~ #2 525181809 ~Q - ~4?'/ ~~
As provided by section 6321, 6322, and 6323 of the Internal Revenue 00 '~~
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Code, we are giving a notice that taxes (including fnterest and penalties) .
have been assessed against the following-named taxpayer. We have trade ~ ~
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a demand for payment of this liability, but it remains unpaid. Therefore, ~,
there is a lien in favor of the 1lnited States on a!! property and rights to
property bebnging to this taxpayer for the amount of these taxes, and ~~- ~ ~2 4 (~ C,/'
additional penalties, interest, and costs that may accrue.
Name of Taxpayer SUSAN M KOPCHO
Residence 63 3 8 N POWDERHORN RD
MECHANICSBURG, PA 17050-8305
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 6325(a).
Tax Period Date of Last Daayy for unpaid Balance
Kind of Tax Ending Identifying Number Assessment Reflling of a~uessment
a) (b (c) (d) e
1040 12/31/2004 XXX-XX-4474 12/31/2007 01/30/2018 43029.92
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 43029.92
This notice was prepared and signed at DETROIT, MI
the 18th day of March 2009
Signature A
for SEAN DUNLEAVY
Title
REVENUE OFFICER
(717) 777-9626
on this,
22-06-1407
(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. 4091 Form 66ft(Yj(c) (Rev. 2-2004)
• Part 1 • Kept fly RecordMg Office CAT. NO 60025X