HomeMy WebLinkAbout09-8590 Department of the Treasury - Internal Revenue Service
Form 668 ( Notice of Federal Tax Lien
(Rev. February 2 2004) 004! IL, . of. ,? I Q r -rL
A Serial Number For Optional Use by Recording Office
rea:
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650
603910309 / yr7' U?
76ct.
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) ?-?- ?a p5
have been assessed against the following-named taxpayer. We have made y 9.77
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
Name of Taxpayer DOUGLAS R COLPETZER
T' `
x'11
Residence 707 HUMMEL AVE ' - '-
LEMOYNE, PA 17043-1832
NT RELEASE INFORMATION: For each assessment listed below,
7 n
e of the lien is refiled by the date given in column (e), this notice shall,
F 7
following such date, operate as a certificate of release as defined
day
the
5(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) b) (c) (d) (e) M
1040 12/31/2002 XXX-XX-4152 11/17/2008 12/17/2018 2053.55
1040 12/31/2003 XXX-XX-4152 11/02/2008 12/02/2018 704.36
1040 12/31/2006 XXX-XX-4152 01/05/2009 02/04/2019 5473.61
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total J$ 8231.52
This notice was prepared and signed at
DETROIT, MI
the 03rd day of December 2009
, on this,
Signature Apl?Q ACS 11-00-0000
for DEBRA K. HURST (800) 829-7650
(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 668(Y)(c) (Rev. 2-2004)
Part I - Kept By Recording Office CAT. NO 60025X