HomeMy WebLinkAbout10-2774Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien 10 _ A1117d PTT
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
646459610
41q.OD PD PLFF
As provided by section 6321, 6322, and 6323 of the Internal Revenue et:?- 10060
Code, we are giving a notice that taxes (including Interest and penalties) p Iq 1 5
have been assessed agahllst 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. r
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Name of Taxpayer BRET E SHELDON 1 ^' -r3 M
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Residence 156 PLEASANT GROVE RD r n
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MECHANICSBURG, PA 17050-1528 a
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 0325(a).
Tax Period Date df Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment R effling of Assessment
(a) b) c d) (e)
1040 12/31/2008 XXX-XX-0488 07/06/2009 08/05/2019 5644.70
Place of Filing
Prothonotary
Cumberland County Total $
Carlisle, PA 17013
5644.70
This notice was prepared and signed at DETROIT, MI
the 20th day of April 2010
, on this,
Signature ? A 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