HomeMy WebLinkAbout04-2759Form 668
Area: I Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 175624904
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 llen 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 DLBRB INC , a Corporation
Residence
1008
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optional Use by Recording Office
5049 RITTER RD
MEC~ANICSBURG, PA 17055-4884
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the llen 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
Kind of Tax Ending Identifying Number Assessment Refiling
(a) (b) (c) (d) (e)
941 06/30/2003 25-1802251 10/06/2003 11/05/2013
941 09/30/2003 25-1802251 12/15/2003 01/14/2014
Unpaid Balance
of Assessment
10929.21
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 29393.93
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 03rd day of June 2004
Sig~ure -~ ~ .~
for DARLENE FISHER
Title
REVENUE OFFICER
(717) 221-3490
23-11-1439
(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 ! - Kept By Recording Office CAT. NO 60025X
Form 668(Z) Department of the Treasury - Internal Revenue Service
(Rev. 10-1999) Certificate of Release of Federal Tax Lien
Serial Number For Use by Recording OIIice
Small BusinesslSelf Employed Area: 3 175624904
I certify that as to the following-named taxpayer, the requirements of section 6325 (a) of the COURT RECORDING INFORMATION
Intemal Revenue Code have been satisfied for the taxes listed below and for all statutory No.04-2759 FTL
additions. Therefore, the lien provided by Code section 6321 for these taxes and additions has
been released. The proper officer in the office where the notice of internal revenue tax lien was
filed on June 16, 2004, is authorized to note the books to show the release of this lien for these
taxes and additions.
Name of Taxpayer
DLBRB INC, a Corporation
Residence
5049 Ritter Rd.
Mechanicsburg, PA 17055-4884
Kind otTax Tax Period Ended Identifying Number Date of Last Day for Unpaid Balance
Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
941 06/30/2003 25-1802251 10/0612003 11/05/2013 $18,464.72
941 09/30/2003 25-1802251 12/15/2003 01/14/2014 $10,929.21
Place of Filing $29,393.93
Prothonotary Total
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at Harrisburg, PA, on this, the 26th day of January. 2005 .
SiLt? .
Dennis P. Zmudzin'~2354
Itle
Revenue Officer, Phone # - 717-221-3490 X131
(NOTE: Certificate of offlcer authorized by law to take acknowledgements is not essential to the vai'idity of Certificate of Relee.. of Federa! Tax Uen Rev. Rut. 71-466,
1971-2 C.B. 409)
Part 1 - Recording Office
Form 668(Z) (Rev. 10-1999)
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