HomeMy WebLinkAbout09-3182Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien 9 318z F T1--
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
546800609
P
Pd-
As
provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
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
additional penalties, interest, and costs that may accrue. c.
c
d O
Name of Taxpayer BRIAN D HUMBLE
,a
Residence 32 FALCON CT ma
MECHANICSBURG, PA 17055-4363
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, v
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last D for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Ref ung of Assessment
(a) (b (c) (d) (e) M
1040 12/31/2003 XXX-XX-1231 12/24/2007 01/23/2018 19892.33
1040 12/31/2004 XXX-XX-1231 12/24/2007 01/23/2018 14403.56
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 34295.89
This notice was prepared and signed at
the 12th day of May
DETROIT, MI
2009
, on this,
Signature t? 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 66SM(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office
CAT. NO 60025X