HomeMy WebLinkAbout09-6789Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien of 7?9 FTi-
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 587787109
As provided by section 6321, 6322, and 6323 of the Internal Revenue ,? yqy
Code, we are giving a notice that taxes (including Interest and penalties)
have been assessed against the following-named taxpayer. We have made ,? 3 s
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. n o
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Name of Taxpayer JEFFREY J COGAN 77 r o
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Residence 20 CARLISLE RD APT 2 r c:
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NEWVILLE, PA 17241-9745 TrF
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RTANT RELEASE INFORMATION: For each assessment listed below, .rte
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notice of the lien is ref fled by the date given in column (e), this notice shall,
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e day following such date, operate as a certificate of release as defined
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6325(a).
Tax Period Date of Last D for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d (e) f)
1040 12/31/2002 XXX-XX-7648 02/18/2008 03/20/2018 6409.71
1040 12/31/2004 XXX-XX-7648 02/18/2008 03/20/2018 8872.79
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 15282.50
This notice was prepared and signed at
DETROIT, MI
the 06th day of October 2009
, on this,
Signature A 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. Rut. 71-466,1971 - 2 C.B. 409)
Part ! - Kept IRecordlim Office Form 668(1 CAT, NO (Rev. '" 2W 5X 1