HomeMy WebLinkAbout10-4635Form 668 (Y)(c)
(Rev. February 2004)
3621
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) 913-6050 674118610
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) n ,
have been assessed against the following-named taxpayer. We have made (
a demand for payment of this liability, but it remains unpaid. Therefore, C - T
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 of Taxpayer JEFFREY A LINE _ _ s=
Residence 11 TOPVIEW DR
CARLISLE, PA 17015-9532
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
iQ. Da •? ??yG?? -!l i
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). ' a(/S1l3
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)
1040 12/31/2004 XXX-XX-8349 06/07/2010 07/07/2020 3217.92
1040 12/31/2007 XXX-XX-8349 06/07/2010 07/07/2020 939.16
1040 12/31/2008 XXX-XX-8349 06/14/2010 07/14/2020 240.35
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 4397.43
This notice was prepared and signed at DETROIT, MI , on this,
the 02nd day of July 2010
Signature A REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(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)
Part 1 - Kept By Recording Office CAT. 668( (Rev. 2-20041
CAT. NO 60025X
3756 Department of the Treasury - Internal Revenue Service
Form 668 (Z) Certificate of Release of Federal Tau Lien
(Rev. 10-2000)
Area: Serial Number For Use by Recordin g Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 674118610
1 certify that the following-named taxpayer, under the requirements of section 6325 (a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and c T
additions has been released. The proper officer in the office where the notice of p3 N
-r
internal revenue tax lien was filed on July 14 rnco
rTt
2010 , is authorized to note the books to show the release of this lien for M;u
'? X-10
M.
these taxes and additions. (T? C:)
Name of Taxpayer -p
JEFFREY A LINE ? 3
(? r y
Residence ll TOPVIEW DR °o
CARLISLE, PA 17015-9532
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
n/a n/a n/a 104635FTL
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Reflling of Assessment
(a) (b) (c) (d) (e) (fl
1040 12/31/2004 XXX-XX-8349 06/07/2010 07/07/2020 3217.92
1040 12/31/2007 XXX-XX-8349 06/07/2010 07/07/2020 939.16
1040 12/31/2008 XXX-XX-8349 06/14/2010 07/14/2020 240.35
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 4397.43
This notice was prepared and signed at
the 07th day of March
Signature
, on this,
Title Director, Campus Compliance
Operations
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Part I - RECORDING OFFICE CAT. NO 600261
DETROIT, MI
2012