HomeMy WebLinkAbout04-2751Form 668 (Y)(¢)
{Rev. February 2004)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA ~3
Lien Unit Phone: (412) 395-5265 174411204
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 0t Taxpayer CLIFTON W GRIFFIT~{S
Residence
1008
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optional Use by Recording Office
3960 INDUSTRIAL PARK ROAD
CAMP HILL, PA 17011-0000
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless natice 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 Perlod Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Retiring of Assessment
(a) (b) (c) (d) (e) (f)
941 03/31/2002 25-1863795 07/01/2002 07/31/2012 721.92
941 09/30/2002 25-1863795 06/23/2003 07/23/2013 7413.92
941 12/31/2002 25-1863795 07/14/2003 08/13/2013 7616.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 15752.59
This notice was prepared and signed at
PHILADELPHIA, PA
_ , on thio,
the 26th da¥of May 2004
Signature,.~ . ~ Title
~3~J~3 - F (717) 221-3490
(~IOT£: Certificate of officer authorized by law to take acknowledgment is net essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 6&8(¥)(c) (Rev. 2-2004)
Part I - Kept By Eecordie8 Office CAT, NO 60025X
Form 109~6(c)
(Rev. 10-2000)
Area: Serial Number
SM/MLL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 174411204
I certify that the following-named taxpayer has met one or more of the elements
of the Internal Revenue Code (IRC) section 6325(j). The Internal Revenue Service
therefore withdraws the Notice of Federal Tax Uen for these taxes and additions.
The withdrawal of this notice of lien does not affect the statutory llen provided
by IRC section 6321; it simply re]inqulthes any lien priority obtained by the internal
Revenue Service when the notice was filed. The proper official, in the office where
the Notice of Federal Tax Uen was filed on June 16, 2 0 04 . ,
is authorized to update the rm~rds to show the withdrawal of the notice of hen
for these taxes and additions.
Name of Taxpayer CLIFTON W GRIFFITHS
Residence
1595 Department of the Treasury - internal Revenue Service
Withdrawal of Filed Notice of Federal Tax Lien
3960 INDUSTRIAL P~d~K ROAD
CAMP HILL, PA 17011-0000
COURT RECORDING INFORM3~TION:
UCC No. Serial No.
NO04 2751 FTL
Date of
Identifying Humber Assessment
(c) (d)
25-1863795 07/01/2002
25-1863795 06/23/2003
25-1863795 07/14/2003
Liber Page
n/a n/a n/a
Tax Period
~nd ~ Tax Ending
(a) (b)
941 03/31/2002
941 09/30/2002
941 12/31/2002
For Opt/onal Use by Recording Office
Mst Day for
Refiling
(e)
07/31/2012
07/23/2013
08/13/2013
Unpaid Balance
of Assessment
721.92
7413.92
7616.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 15752.59
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 13th day of.~ 1,,~u~.z
Cat. No. 24586T
2004
Title Compliance Technical Support
Manager
Part I - Recording Office
Forml0916(C) (Rev. 10-2000)