HomeMy WebLinkAbout09-62882447
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) ?. 6 Y. Qg" F7-4
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
o
Lien Unit Phone: (800) 829-3903 580767009 t
-(,
As provided by section 6321, 6322, and 6323 of the Internal Revenue Qb9?
Code, we are giving a notice that taxes (including Interest and penalties)
have been assessed against the following-named taxpayer. We have made 3 p g 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
C
- r
additional penalties, interest, and costs that may accrue. -
-Z
-
-
T
J;
Name of Taxpayer FRED C MILLER rr r--
i
y.' F
Residence 1510 THOMPSON LN
MECHANICSBURG, PA 17055-6732 cFn
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).
Tax Period Date of Last Day for Unpaid ;Balance
Kind of Tax Ending Identifying Number Assessment Refi g of Assesment
(a) (b) (c) (d) (e
1040 12/31/2008
1 XXX-XX-2678 06/22/2009 07/22/2019 1411.02
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 1411.02
This notice was prepared and signed at DETROIT, MI
the 11th day of September 2009
, on this,
Signature Nf--k ? 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)
Part I - Kept By Recording Office CAT. 668( (Rev. 2 20041
CAT. NO 60025X