HomeMy WebLinkAbout09-4804Form 668 (Y)(c)
(Rev. February 2004)
804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien )% o q_ (1 po y F TL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
563846509 /1
n? 7' I" >!~ , (J1
Lien Unit Phone: (800) 829-3903
As provided by section 6321, 6322, and 6323 of the Internal Revenue Gj- 6369
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made , .? ? 817 9
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 JOHN R & BERNICE M BARTON
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t
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r
Residence
101 OLD FORD DR
r°' .
C1
CAMP HILL, PA 17011 , i;
NT RELEASE INFORMATION: For each assessment listed below,
IMPOR Z -1
unless ne of the lien is refiled by the date given in column (e), this notice shall,
:
on the following such date, operate as a certificate of release as defined
y
3
2
in IFIC 5(a).
Tax P
eriod
Date of
Last Day for
Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2007 XXX-XX-7304 12/01/2008 12/31/2018 2579.48
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 2579.48
This notice was prepared and signed at
the 09th day of July
DETROIT, MI
2009
, on this,
Signature IK? A 'Y? 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(1 (Rev. 1
Part 1 - Kept By Recording Office CAT. NO 60025X
025X
CAT