HomeMy WebLinkAbout09-2397Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~ a 9 ,~ 3 ~ ~ ~ r~
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S For Optional Wse by Recording Office
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SMALL BUSINESS/SELF EMPLOYED AREA #2 ,~ G t,~f ~'/9 v~
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Lien Unit Phone: (800) 829-3903 532915409 //~i
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As provided by section 6321, 6322, and 6323 of the Internal Revenue ~ Y/io
Code, we are giving a notice that taxes (includMg interest and penalties)
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have been assessed agahtst the folbwing-named taxpayer. We have ma • ~
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a Ikn in favor of the United States on all property and rights to -~~ ~_~` ~. •-~
property belonging to this taxpayer for the amount of these taxes, and ` ~'' ' ~ ~~
additional penaltks, interest, and costs that may accrue. `s~'
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Name of Taxpayer RICHARD B WICKERSHAM ~
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Residence 682 SAINT JOHNS DR ~
CAMP HILL, PA 17011-1337
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
Kind of Tax Ending Identifying Number Assessment Reflling
1040 12/31/2003 XXX-XX-4502 01/09/2006 02/08/2016
1040 12/31/2003 XXX-XX-4502 01/09/2006 02/08/2016
1040 12/31/2004 XXX-XX-4502 11/07/2005 12/07/2015
Place of Filing
DETROIT, MI
Total ~$ 17264.63
This notice was prepared and signed at
the 07th day of April
unpaid Balance
of Assessment
171.61
17093.02
on this,
2009
Signature A ACS 22-00-0008
for MICHAEL W. COX (800) 829-3903
Prothonotary
Cumberland County
Carlisle, PA 17013
(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)
Part 1 -Kept By Recording Office CAT. NO 60025X