HomeMy WebLinkAbout10-1841Form 668 (Y)(c)
(Rev. February 2004)
2447
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 631844310
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
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.
Name of Taxpayer JEREMY L AYERS
For Optional Use by Recording Ottice
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;- aas 969
Residence 29 MOUNTAIN ST
MT HOLLY SPRINGS, PA 17065-1407
EIRC NT :Iien E INFORMATION: For each assessment listed below,
e of trefiled by the date giv en in column (e), this notice shall,
folloh date, operate as a certificate of release as defined
5(a).
Tax Period Date of Last Day f or Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2006 XXX-XX-7518 06/22/2009 07/22/2019 6779.23
0 0
:
Y
ca y
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Place of Filing
05th day of March
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
the
Signature
DETROIT, MI
2010
Total 1$ 6779.23
, on this,
fnr nR.RRA K HURST
Title
ACS
(800) 829-7650
11-00-0000
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of reaerai i ax 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