HomeMy WebLinkAbout09-4174Form 668 (Y)(c)
(Rev. February 2004)
2447
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien -?? n c, -) y r`
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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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 , .3 ?.
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.
Name of Taxpayer DEBRA A BROUGH '
Residence 591 GENEVA DRIVE ?_O
MECHANICSBURG, PA 17055-5472
IMPORTANT RELEASE INFORMATION: For each assessment listed below, = f_
unless notice of the lien is refiled by the date given in column (e), this notice shall, - G ,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) M
CIVP 06/30/2005 XXX-XX-7793 08/04/2008 09/03/2018 8199.30
CIVP 09/30/2005 XXX-XX-7793 08/04/2008 09/03/2018 12906.63
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 21105.93
This notice was prepared and signed at
the 11th day of June
DETROIT, MI
2009
on this,
Signature A \Y-h? 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. 2-2004)
Part 1 -Kept By Recording Office CAT, Nio F0n25X