HomeMy WebLinkAbout10-1840Form 668 (Y)(c)
(Rev. February 2004)
2447
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 #7
Lien Unit Phone: (800) 913-6050
631740810
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As provided by section 6321, 6322, and 6323 of the internal Revenue d?q, DO
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made QUy r
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 3 8 1?0 S
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JAMIE H JOHNSON
Residence 103 STANFORD CT
MECHANICSBURG, PA 17050
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,
on the day following such date, operate as a certificate of release as defined
in IRC 63251a1•
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)
1040 12/31/2004 XXX-XX-7679 12/11/2006 01/10/2017 37.39
1040 12/31/2006 XXX-XX-7679 05/28/2007 06/27/2017 2524.97
1040 12/31/2007 XXX-XX-7679 06/09/2008 07/09/2018 3533.90
1040 12/31/2008 XXX-XX-7679 08/22/2009 09/21/2019 743.56
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 6839.82
This notice was prepared and signed at
the 04 th day of March
DETROIT, MI
2010
, on this,
Signature A Title
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 1 - Kept By Recording Office CAT. NO 60025X