HomeMy WebLinkAbout09-6108Form 668 (Y)(c)
(Rev. February 2004)
4804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien 0 9 ( / o P F r?
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 577759109
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.
ame of Taxpayer ELIZABETH J
Residence 502 JACOB LN
MECHANICSBURG, PA 17050-7218
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
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
in IRC 6325(a).
For Optional Use by Rec
3-0.2 3
a 303.21
Tax Period Date of Last Day for
Kind of Tax Ending Identifying Number Assessment Refilling
(a) (b) _ (c) (d) (e)
1040 112/31/20061 XXX-XX-4668 04/15/2007 05/15/2017
1040 12/31/2006 XXX-XX-4668 09/29/2008 10/29/2018
1040 12/31/2006 XXX-XX-4668 109/29/20081 10/29/2018
Place of Filing
19397.24
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 19397.24
This notice was prepared and signed at
DETROIT, MI
the 01st day of September 2009
, on this,
Title
Signature A A
22-00-0008
CS
for MICHAEL W. COX (800) 829-3903
Office
Cl) _63
C
-0 Cn
M rT- r r1
d c ' -a
co ZZ)
T
C M
? w
C1'e ' C
Unpaid Balance
of Assessment
(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