HomeMy WebLinkAbout09-5121Form 668 M(c)
(Rev. February 2004)
6152
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien N c).
Serial Number
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 566645609
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
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 WILLIAM H RIVELY
Residence 137 S 32ND ST
CAMP HILL, PA 17011-5101
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LinIRC ORTANT RELEASE INFORMATION: For each assessment listed below,
s notice of the lien is refiled by the date given in column (e), this notice shall,
e day following such date, operate as a certificate of release as defined
6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiiing of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2004 XXX-XX-8006 04/13/2009 05/13/2019 3341.31
1040 12/31/2005 XXX-XX-8006 04/13/2009 05/13/2019 3806.71
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
the 21st day of July 2009
, on this,
tle
Signature A ACS
11-00-0000
for DEBRA K. HURST (800) 829-7650
(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
Total $ 7148.02