HomeMy WebLinkAbout09-3993 4804
Department of the Treasury - Internal Revenue Service
Form 668 (2)04) Notice of Federal Tax Lien -
'
(Rev. February 2004) ,Q 7L-
3 993 F
Serial Number For Optional Use by Recording Office
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050
554139309 Q yJ$ s?gr?
I:
// 00
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penakies) et- 5 s -k
have been assessed against the following-named taxpayer. We have made
(' Y
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 n r'a
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, Interest, and costs that may accrue. ? c?
rij
Name of Taxpayer HERBERT A TERRELL
cr1 ? ; ?
Residence 1075 LANCASTER BLVD APT 5
MECHANICSBURG, PA 17055-4473 '-- r1;
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 Period Date of Last ppa?yy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a b c d) e
1040 12/31/2007 XXX-XX-7013 04/27/2009 05/27/2019 10454.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total J$ 10454.75
This notice was prepared and signed at
the 05th day of June
DETROIT, MI
2009
, on this,
Signature -)? A Title
REVENUE OFFICER 22-06-1442
for DAVID M. SHROYER (717) 777-9625 x1320
(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 RecordinE Office CAT. NO 60025X