HomeMy WebLinkAbout09-5954Form 668 (Y)(c)
(Rev. February 2004)
2
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 574717309 o9 - S 1-.??.._.,,
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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)
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have been assessed against the following-named taxpayer. We have made cL
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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 S1 5.?
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property belonging to this taxpayer for the amount of these taxes, and .
additional penalties, interest, and costs that may accrue.
Name of Taxpayer KENNIE JAMISON 2' a.3 6667
Residence 3789 SPRING RD
CARLISLE, PA 17013-8705
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
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following such date, operate as a certificate of release as defined
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RC
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5(a).
Tax Period Date of Last Day f or Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Ref illing of Assessment
(a) (b) (c) (d) ( e) (f)
1040 12/31/2007 XXX-XX-5221 10/13/2008 11/12/2018 6157.62
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 6157.62
This notice was prepared and signed at DETROIT, MI
the 20th day of August 2009
, on this,
Signature /?- H l/-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. NO 60025X