HomeMy WebLinkAbout09-8450Form 668 (Y)(c)
(Rev. February 2004)
447
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien yL o 9, P 9 ?-o F- 7-L.
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
602181209
P e19 U-0
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck-- h q J y
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made 1314(,11-7
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.
.ss
Name of Taxpayer DAVID S WELLS
t
Residence 110 OLD SAW MILL DR
NEWBURG, PA 17240-9399 a
r
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, ilt
on the day following such date, operate as a certificate of release as defined
o
i
n I 6325(a).
Tax Period Date of Last Dar?rr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) b) (c) (d) (e) f)
1040 12/31/2008 XXX-XX-9458 06/01/2009 07/01/2019 3832.48
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 3832.48
This notice was prepared and signed at DETROIT, MI _ , on this,
the 26th day of November 2009
Signature ? A 'Y?' 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 1 - Kept By Recording Office CAT. 668( AT (Rev. 2-2004)
G. NO 60025X