HomeMy WebLinkAbout04-2354
1008
Department of the Treasury - Internal Revenue Service
form 668 (Y)(c)
Notice of Federal Tax Lien
7t,IJ'I- .)35'1 FTt-
For Optional Use by Recording Office
Ii r 1'1 lID
(Rev. February 2004)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
lien Unit Phone: (412) 395-5265 172207304
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 MICHAEL D SWICK DMD
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Residence
4767 ROUTE 8
ALLISON PARK, PA 15101-0000
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiJed by the date given in column (el. this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325Ia).
Kind of Tax
(a)
941
Tax Period
Ending
(b)
12/31/2003
Identifying Number
(c)
25-1381694
Date of
Assessment
(d)
03/15/2004
Last Day for
Reflling
(e)
04/14/2014
Unpaid Balance
of Assessment
(f)
3056.90
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Tota' $
3056.90
This notice was prepared and signed at
PHILADELPHIA, PA
_ ,on this,
the
12th day of May
2004
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Signature ;" ~_-#-I:
for q;~lJ'~ON
f?
~A1./
Title
REVENUE OFFICER
(724) 772-5103 x1340
23-11-2122
(HOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ru!' 71.466, 1971 - 2 C.B. 409}
Part 1 . Kept By Recording Office
Fmm 668(Y)(c) IRev. 2-2004)
CAT. NO 60025X
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1872
Department of the Treasury - Internal Revenue Service
Certificate of Release of Federal Tax Lien
Form 668 (Z)
(Rev. 10-20001
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 172207304
I certify that the following-named taxpayer, under the requirements of section 6325 {al
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on May 25
2004 , is authorized to note the books to show the release of this lien for
these taxes and additions.
For Use by Recordin Office
Name of Taxpayer
MICHAEL D SWICK DMD
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I
Residence 4 767 ROUTE 8
ALLISON PARK, PA 15101-0000
Liber
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Page
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COURT RECORDING INFORMATION:
DCC No. Serial No.
n/a 04-2354 FTL
Tax Period Date of Last Day fo
Kind of Tax Ending Identifying Number Assessment Reflhng
fa) Ib) Ie) Id) Ie)
941 12/31/2003 25-1381694 03/15/2004 04/14/20 4
******** ********** ************* ********** ********* **
Unpaid Balance
of Assessment
If)
n ::::;3 0 ?-? . 90
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
T tal $
3056.90
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
16th day of March
2005
Signature
Title Director, Pa ent Compliance
(NOTE: Certificate of officer authorized by Jaw to take acknowledgments is not essential to the vaidity of Certificate of Release of
Federal Tax lien Rev. Rut 71-466, 1971 - 2 C.B. 4091
Pa.. 1 - RECORDING OFFICE
Fo,m 668 (Z) IRev. 10-20001
CAT NO 600261