HomeMy WebLinkAbout10-2777Form 668 (Y)(c)
(Rev. February 2004)
2447
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien its .vim 1-nn
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
646484110
41Q.ov PO PLF-F
As provided by section 6321, 6322, and 6323 of the Internal Revenue C,6* 10050
Code, we are giving a notice that taxes (including interest and penahies) 00141157
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.
Z7
Name of Taxpayer DIANNE L ROTH
n
C
r';
Residence 401 HALDEMAN BLVD -° C)
NEW CUMBERLND, PA 17070-1230
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 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refili ng of Assessment
(a) (b) c (d (e) M
1040 12/31/2005 XXX-XX-8723 05/29/2006 06/28/2016 2112.17
1040 12/31/2006 XXX-XX-8723 05/28/2007 06/27/2017 4907.55
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 7019.72
This notice was prepared and signed at
DETROIT, MI
the 20th day of April 2010
, on this,
Signature )? A \Y? ACS tle
22-00-0008
for MICHAEL W. COX (800)1-829-3903
(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 Offlce CAT. NO 60025X