HomeMy WebLinkAbout09-24325
Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien ~, n y. ~ y~~ F`rL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 ~~ ~~~ ~ /~% ~
534751009
As Provided by section 632 t , 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penahks) ~ ~- y ~ ~° ~
have been assessed against the following-named taxpayer. We have made
a demand for payment of thLt liability, but it remains unpaid. Therefore, ~ ~•
~~• ~ a 3
there is a lien in favor of the United States on all property and rights to
Property belonging to this taxpayer for the amount of these taxes, and n N
~-
addhional penakies, interest, and costs that may accrue. ~~ ~`'~
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Name of Taxpayer JEFFREY G HAYES ~ r ~~ ~
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rw. ~ .~,1 -, rY
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Residence
8 DICKINSON AVE APT D _ `~ `~ -*i
='-: ,-= .: . ,. ~-,
CAMP HILL, PA 17011-5415 ~ =-; rv ; ~t`rl
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IMPORTANT RELEASE INFORMATION: F
h
li `' ~
or eac
assessment
sted 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).
Kind of Tax Tax Period
Endh~g
Identiilying Number Date of
Assessme~ Last Daayy for
Reflling Unpaid Balance
of Assessment
(a (b (c) d (e
1040 12/31/2003 XXX-XX-2485 02/09/2009 03/11/2019 3008.57
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 3008.57
This notice was prepared and signed at
the 10th day of April
Signature
for JAKOB
DETROIT, MI
2009
on this,
Title
REVENUE OFFICER
(717) 777-9621
22-06-1418
(NVfE: 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)
Part 1 - K t Form 668(n(c) (Rev. 2-2004)
ep By R«°rd~°8 OKIu CAT. NO 60025X