HomeMy WebLinkAbout10-3795Form 668 (Y)(c)
(Rev. February 2004)
1
Department of the Treasury - Internal. Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
662120210 ?74s
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 0 k? /?Od
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 233??
property belonging to this taxpayer for the amount of these taxes, and 0
additional penakies, interest, and costs that may accrue. o
o
Name of Taxpayer PETER J OWEN cx? c
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u
Residence
2801 MARKET ST APT 4 r O6 ,
CAMP HILL, PA 17011-4534 3'"?
rtz
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co
NT RELEASE INFORMATION: For each assessment listed below,
IMPO
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h
ll
il
i
i
l
hi
s not
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ed by the date g
ven
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a
unless e of the lien is ref
umn (e), t
7
on the following su ch date, operate as a certificate of release as defined
da
in IRC 5(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Re lung of Assessment
(a) b (c) d) (e) M
1040 12/31/2000 XXX-XX-9821 03/24/2008 04/23/2018 35459.40
1040 12/31/2001 XXX-XX-9821 03/24/2008 04/23/2018 50271.12
1040 12/31/2003 XXX-XX-9821 03/24/2008 04/23/2018 44388.93
1040 12/31/2004 XXX-XX-9821 03/24/2008 04/23/2018 27126.41
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 157245.86
This notice was prepared and signed at
DETROIT, MI
the 01st day of June 2010
, on this,
tle
Signature A ACS
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 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 60025X