HomeMy WebLinkAbout09-3184Form 668 (Y)(c)
(Rev. February 2004)
4804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien -n, 6 4- 3) 7y r rt-
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
-
Y'
Lien Unit Phone: (800) 829-3903
545058409 77
As provided by section 6321, 6322, and 6323 of the Internal Revenue yd??
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made ,1 ?S 33/
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 r
additional penalties, interest, and costs that may accrue. „
Name of Taxpayer DAVID S WELLS '
< rn
Residence
110 OLD SAW MILL DR
NEWBURG, PA 17240-9399 ... ''
IMPORTANT RELEASE INFORMATION: For each assessment listed below, cam.)
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 Darr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2006 XXX-XX-9458 06/18/2007 07/18/2017 4257.75
1040 12/31/2007 XXX-XX-9458 05/26/2008 06/25/2018 3749.01
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 8006.76
This notice was prepared and signed at
the 07th day of May
DETROIT, MI
2009
, on this,
Title
Signature tiZeQ A
CS 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. 2-2004)
Part I - Kept By Recording Office CAT. NO 60025X