HomeMy WebLinkAbout09-6485I
Form 668 (Y)(c)
(Rev. February 2004)
5
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien 6 q - y o 4 it-' rL-
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 583155209
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
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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
property belonging to this taxpayer for the amount of these taxes, and N
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additional penakies, interest, and costs that may accrue. .
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Name of Taxpayer JEFFREY L JOHNSON
., T
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Residence 12 S FILBERT ST APT C7
MECHANICS, PA 17055-6551 ' ha `yip
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PORTANT RELEASE INFORMATION: For each assessment listed below, .
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ess notice of the lien is refiled by the date given in column (e), this notice shall,
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the day following such date, operate as a certificate of release as defined
RC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment ReMng of Assessment
(a) b) (c) d (e)
1040 12/31/2003 XXX-XX-5929 10/27/2008 11/26/2018 5101.43
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 5101.43
This notice was prepared and signed at
DETROIT, MI
the 18th day of September 2009
, on this,
Signature `
for MICHAEL W. COX
ACS
(800) 829-3903
22-00-0008
(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 66SM(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT_ Nn Rnn2sx