HomeMy WebLinkAbout10-1557Form 668 (Y)(c)
(Rev. February 2004)
447
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
628997610
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) Q. U v
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore, CK /3093
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 l Y
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additional penalties, interest, and costs that may accrue. o
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Name of Taxpayer ALEXANDE R DOLATOSKI G `= n
Residence 3319 LISBURN RD ''
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MECHANICSBURG, PA 17055-6715 h
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NT RELEASE INFORMATION: For each assessment listed below,
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une of the lien is refiled by the date given in column (e), this notice shall,
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on following such date, op erate as a certificate of release as define
theday O
in 5(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
CIVP 09/30/2005 XXX-XX-1926 03/30/2009 04/29/2019 19684.11
CIVP 12/31/2005 XXX-XX-1926 12/07/2009 01/06/2020 8093.25
CIVP 03/31/2006 XXX-XX-1926 12/07/2009 01/06/2020 20692.80
CIVP 06/30/2006 XXX-XX-1926 12/07/2009 01/06/2020 17334.40
CIVP 09/30/2006 XXX-XX-1926 12/07/2009 01/06/2020 18198.63
CIVP 12/31/2006 XXX-XX-1926 12/07/2009 01/06/2020 12396.37
CIVP 03/31/2007 XXX-XX-1926 12/07/2009 01/06/2020 3094.29
CIVP 06/30/2007 XXX-XX-1926 12/07/2009 01/06/2020 16711.94
CIVP 09/30/2007 XXX-XX-1926 12/07/2009 01/06/2020 12256.90
CIVP 12/31/2007 XXX-XX-1926 12/07/2009 01/06/2020 10433.04
CIVP 03/31/2008 XXX-XX-1926 12/07/2009 01/06/2020 572436.38
CIVP 06/30/2008 XXX-XX-1926 12/07/2009 01/06/2020 1735.13
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 713067.24
This notice was prepared and signed at
the 25th day of February
DETROIT, MI
2010
, on this,
Signature \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) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025x
Form 668 (Z) 11883 Department of the Treasury - Internal Revenue Service
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 628997610 7
J
/ D ^ / SS
1 certify that the following-named taxpayer, under the requir ements of section 6 325 (a)
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 tax es and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on March 05 °'M -`
2010 , is authorized to note the books to show the release of this l ien for ==w
these taxes and additions. t
Name of Taxpayer r _.
ALEXANDE R DOLATOSKI
Residence3319 LISBURN RD --
MECHANICSBURG, PA 17055-6715
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
n/a n/a n/a 10-1557FTL o-2S
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) fc) (d) (e) (f)
CIVP 09/30/2005 XXX-XX-1926 03/30/2009 04/29/2019 19684.11
CIVP 12/31/2005 XXX-XX-1926 12/07/2009 01/06/2020 8093.25
CIVP 03/31/2006 XXX-XX-1926 12/07/2009 01/06/2020 20692.80
CIVP 06/30/2006 XXX-XX-1926 12/07/2009 01/06/2020 17334.40
CIVP 09/30/2006 XXX-XX-1926 12/07/2009 01/06/2020 18198.63
CIVP 12/31/2006 XXX-XX-1926 12/07/2009 01/06/2020 12396.37
CIVP 03/31/2007 XXX-XX-1926 12/07/2009 01/06/2020 3094.29
CIVP 06/30/2007 XXX-XX-1926 12/07/2009 01/06/2020 16711.94
CIVP 09/30/2007 XXX-XX-1926 12/07/2009 01/06/2020 12256.90
CIVP 12/31/2007 XXX-XX-1926 12/07/2009 01/06/2020 10433.04
CIVP 03/31/2008 XXX-XX-1926 12/07/2009 01/06/2020 572436.38
CIVP 06/30/2008 XXX-XX-1926 12/07/2009 01/06/2020 1735.13
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 713067.24
This notice was prepared and signed at
the 23rd day of February
Signature
, on this,
Title Director, Campus Compliance
Operations
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Part 1 - RECORDING OFFICE
CAT. NO 600261
DETROIT, MI
2011
4-1-1411