HomeMy WebLinkAbout10-3710Form 668 MW
(Rev. February 2004)
4804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien A
n. l4 - 3 7 /D FT?-
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 661649410
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
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a demand for payment of this liability, but it remains unpaid. Therefore, ix
there is a lien in favor of the United States on all property and rights to rz., c
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property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer FORBES CHEVROLET INC, a Corporation ?' i°= F?
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Residence 3400 HARTZDALE DR
CAMP HILL, PA 17011-7213 ?/1? ?(1 dd 1??
IMPORTANT RELEASE INFORMATION: For each assessment listed below, /01376
unless notice of the lien is refiled by the date given in column (e), this notice shall,
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e
on the day following such date, operate as a certificate of release as
in IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
941 12/31/2007 23-1947103 03/10/2008 04/09/2018
941 12/31/2007 23-1947103 07/20/2009 08/19/2019 5865.18
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 5865.18
This notice was prepared and signed at DETROIT, MI
the 28th day of May 2010
, on this,
Signature
)K? A ATitle
CS 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 I ax 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