HomeMy WebLinkAbout09-4485Form 668 (Y)(c)
(Rev. February 2004)
6152
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien -n, h4 Lfq Ss F TL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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194
Lien Unit Phone: (800) 913-6050 560777309
As provided by section 6321, 6322, and 6323 of the Internal Revenue Gam. S g 9-L
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made n z' z
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. ?n- C= 0?
Name of Taxpayer HAROLD S IRWIN III i
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Residence 606 MOORELAND AVE Cn
CARLISLE, PA 17013-3730
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NT RELEASE INFORMATION: For each assessment listed below,
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unless ne of the lien is refiled by the date given in column (e), this notice shall,
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on the following such date, operate as a certificate of release as defined
in lRC 5(a).
Tax Pe
riod
Date of
Last Day for
Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2008
1 XXX-XX-8289 06/01/2009 07/01/2019 17290.33
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total J$ 17290.33
This notice was prepared and signed at
the 26th day of June
Signature A Title ;r<r REVENUE OFFICER 22-06-1442
for DAVID M. SHROYER (717) 777-9625 x1320
DETROIT, MI
, on this,
2009
(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. NO 60025X