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HomeMy WebLinkAbout09-2430Form 668 (Y)(c) (Rev. February 2004) Department of the Treasury -Internal Revenue Service Notice of Federal Tax lien -~. v ~, ~ y ~ ~ ~ T,. Area: Serial Number For Optional Use by Recordin g Office SMAi,L BUSINESS/SELF EMPIAYED AREA #2 Lien Unit Phone: (800) 913-6050 534125409 ~~, ~,~/' ~Y ~ /~ (I~ AS provided by section 6321, 6322, and 6323 of the Internal Revenue y ~~ ~ Code, we are giving a notice that taxes (including interest and penaftks) «- have been assessed against the followring-named taxpayer. We have made G~ ,~ ,1 3 a~ b' ~ a demand for payment of this liability, but it remains unpaid. Therefore, , there is a Ikn in favor of the United States on al! property and rights to r,,, property belonging to this taxpayer for the amount ~ these taxes, and c~-`_ additional penalties, interest, and costs that may accrue. ~ ~ ;~. ~ Name of Taxpayer CARL M PEFFLEY JR. DMD FC a Corporate n ~ `~~ a w~ lj~ ', l .yC_~+ i Residence 4003 TRINDLE RD _ ~_ ~ '<<' ` ~ ~ CAMP HILL, PA 17011-4248 - ~ . .~ ~ cn ~ 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 Perbd Date of Lla~y for Last Unpaid Balance Kind of Tax Ending Identifying Number Assessment Re filing of Assessment a) b c d) e 941 03/31/2008 23-1966746 09/01/2008 10/01/2018 7 255.01 941 06/30/2008 23-1966746 09/29/2008 10/29/2018 147.96 Place of Filing This notice was prepared and signed at DETROIT, MI Prothonotary Cumberland County Carlisle, PA 17013 Total ~$ 7402.97 the 09th day of April 2009 on this, Signature ~ ~ ~/y1~~~ RtIEVENUE OFFICER 22 - 06 -14 0 7 for SEAN DUNLEAVY (717) 777-9626 - - - (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax Tien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(n(c) iRev. 2-20041 Part t -Kept By Itetordin~ Office CAT. NO 60025X 11883 Department of the Treasury - Internal Revenue Service Form 668(Z) (Rev. 10-2000) Certificate of Release of Federal Tax Lien Area: Serial Number For Use by Recording Office SMALL BUSINESS/SELF EMPLOYED AREA #2 Lien Unit Phone: (800) 913-6050 534125409 1 certify that the following-named taxpayer, under the requirements of section 6325 (a) - 4136) IC ?(, of the Internal Revenue Code has satisfied the taxes listed below and all statutory additions. Therefore, the lien provided by Code section 6321 for these taxes and additions has been released. The proper officer in the office where the notice of internal revenue tax lien was filed on April 17 _ 2009 , is authorized to note the books to show the release of this lien for C ??r7 these taxes and additions. Name of Taxpayer =M Xw- rn CARL M PEFFLEY JR DMD PC, a Corporation w C3 -cam Residence 4 0 0 3 TRINDLE RD ?-n CAMP HILL, PA 17011-4248 "-- C:) cn COURT RECORDING INFORMATION: Liber Page UCC No. Serial No. / fa, 14 n a n/a n/a 09-2430 FTL ts U Tax Period Date.of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refiling of Assessment (a) (b) (c) (d) (e) (f) 941 03/31/2008 23-1966746 09/01/2008 10/01/2018 7255.01 941 06/30/2008 23-1966746 09/29/2008 10/29/2018 147.96 ******** ********** ************* ********** ************ **************** Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total 1 $ 7402.97 This notice was prepared and signed at the 19th day of January Signature DETROIT, MI 2011 , on this, Title Director, Campus Compliance Operations '441 1 (NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000) Part 1 - RECORDING OFFICE CAT. NO 600261