HomeMy WebLinkAbout09-6182Form 668 (Y)(c)
(Rev. February 2004)
4804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Y11?./14.6 IP2
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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one: (800) 829-3903 579319609
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) C? y3
have been assessed against the following-named taxpayer. We have made z 3 y 9 V
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 RICKY L MOTTER n
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Residence 39 MOTTER DR
SHIPPENSBURG, PA 17257-9734 _73
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless noe of the lien is refiled by the date given in column (e), this notice shall,
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on the day following such date, operate as a certificate of release as defined `+ ••
in IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) b) (c (d) (e) (f)
1040 12/31/2006 XXX-XX-6527 05/11/2009 06/10/2019 11792.16
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 11792.16
This notice was prepared and signed at DETROIT, MI
the 04th day of September 2009
, on this,
Signature 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) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X