HomeMy WebLinkAbout09-4628Form 668 (Y)(c)
(Rev. February 20041
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien yn^ V/ a ?TL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
562231809 /?
"?(. /'w
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck y?
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;
Name of Taxpayer ALEXIS J POLLACK -
?
Residence 12 BRIER RD -
CAMP HILL, PA 17011-2512
IMPORTANT RELEASE INFORMATION: For each assessment listed below, _? y +
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 c. , C
in IRC 6325(a).
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Da for
RerLg Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2002 XXX-XX-7164 01/05/2009 02/04/2019 5178.81
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 5178.81
This notice was prepared and signed at
the 02nd day of July
DETROIT, MI
2009
, on this,
Signature ?- H -Y?? 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)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X
6152 Department of the Treasury - Internal Revenue Service
Form 668 (Z)
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use b Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Ph
Li
i
U
562231809 _? 9
00
A
one: (800) 913-6050
en
n
t _
1 certify that the following-named taxpayer, under the requirements of section 6325 (a) C1*1 3-V 7Z
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and (7 q 6 p.s
9
additions has been released. The proper officer in the office where the notice of 1,
internal revenue tax lien was filed on July 10
2009 , is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer
ALEXIS J POLLACK
CD
?
-
try,
' C-
Residence 12 BRIER RD c5 "I-
CAMP HILL, PA 17011-2512 rv_ t
s
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No. `?-C_ na err`,
n/a n/a n/a 09-4628
Tax Period Date of Last Day for tJnpailalnce
Kind of Tax Ending Identifying Humber Assessment R euling of Assessment
a (b) a) d (091 f
1040 12/31/2002 XXX-XX-7164 01/05/2009 02/04/2019 5178.81
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 5178.81
This notice was prepared and signed at
the 12th day of August
DETROIT, MI
2009
, on this,
Signature A I Title Director, Campus Compliance
Operations
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Fart 1 - RECORDING OFFICE CAT. k!O 600261