HomeMy WebLinkAbout10-3073Form 668 (Y)(c)
(Rev. February 2004)
11883
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien Ib _ 3073 r=TL
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650
651868210
414.00 Pb
PLFF
As provided by section 6321, 6322, and 6323 of the Internal Revenue C-* 1oi
Code, we are giving a notice that taxes (including interest and penalties) ay 1 BZ7
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. ,?
.
° 1
-
3-,
Name of Taxpayer TODD E DAVIS ¢
Residence
1003 NANROC DR APT 32 s
-C -i ,
MECHANICSBURG, PA 17055-4480
IMPORTANT RELEASE INFORMATION: For each assessment listed below, c?
unless notice of the lien is refiled by the date given in column (e), this notice shall, ? 'C
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 Refilng of Assessment
(a) (b) (c) d) (e) (f)
1040 12/31/2002 XXX-XX-5803 05/07/2007 06/06/2017 385.31
1040 12/31/2004 XXX-XX-5803 05/07/2007 06/06/2017 2730.16
1040 12/31/2005 XXX-XX-5803 06/09/2008 07/09/2018 2379.12
1040 12/31/2006 XXX-XX-5803 06/09/2008 07/09/2018 1809.04
1040 12/31/2007 XX:K-XX-5803 05/26/2008 06/25/2018 346.66
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total p$ 7650.29
This notice was prepared and signed at
the _ 04th day of May
DETROIT, MI
2010
, on this,
Signature /?- y 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 F0025X