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HomeMy WebLinkAbout09-2912Form 668 (Y)(c) (Rev. February 2004) 244 Department of the Treasury - Internal Revenue Service Notice of Federal Tax Lien -,, 6q. Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS,/SELF EMPLOYED AREA #2 Lien Unit Phone: (800) 829-3903 542042609 As provided by section 6321, 6322, and 6323 of the Internal Revenue 3 3 3? Code, we are giving a notice that taxes (including interest and penalties) C? have been assessed against the following-named taxpayer. We have made a demand for payment of this liability, but it remains unpaid. Therefore, © c? 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 rp 7- ?{ 2;x- M additional penalties, interest, and costs that may accrue. Name of Taxpayer DANIEL K & JENNIFER A BERGEY ..r ? Residence 1022 TRINDLE RD CARLISLE, PA 17013-2629 CCn -< NT RELEASE INFORMATION: For each assessment listed below, e of the lien is refiled by the date given in column (a), this notice shall, F 7 da following such date, operate as a certificate of release as defined 5(a). Tax Per iod Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Ref iling of Assessment (a) (b) (c) (d (e) (f) 1040 12/31/2006 XXX-XX-2785 05/28/2007 06/27/2017 62 38.50 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total 1$ 6238.50 This notice was prepared and signed at DETROIT, MI , on this, the 30th day of April 2009 Signature A Title ACS 22-00-0008 for MICHAEL W. COX (800) 829-3903 (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(Y)(c) (Rev. 2-20041 Part 1 - Kept By Recording Office CAT. NO 60025X