HomeMy WebLinkAbout10-4684Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #
Lien Unit Phone: (800) 829-7 50 671001510 v
I
As provided by section 632 , 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against t e following-named taxpayer. We have made -
a demand for payment of th liability, but it remains unpaid. Therefore, p -n
there is a lien in favor of the United States on all property and rights to -V T c _ -r
property belonging to this er for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer ANDREW P LENTINE (-
r
Residence 16077 BU T MILL RD D
NEWBURG, PA 17240-9657 ?L
IMPORTANT RELEASE IMF RMATION: For each assessment list
below,
:
unle
ss notice of the lien is refiled by the date given in column (e), this notll,
)g, QQ
rd
on the day following such date, operate as a certificate of release as d
in IRC 6325(a). A o?VS3,F
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending 1 entifying Number Assessment Re filing of Assessment
(a) b) c (d e) f)
1040 12/31/2001 XXX-XX-6672 05/27/2002 06/26/2012 9876.10
1040 12/31/2002 -XX-6672 06/14/2004 07/14/2014 2932.68
1040 12/31/2003 -XX-6672 06/28/2004 07/28/2014 769.74
Place of Filing
Prothono ary
Cumberla d County
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
the 24th day of June I 2010
, on this,
Total J$ 13578.52
Signature A ACS
for DEBRA K. HURST (800) 829-7650
(NOTE: Certificate of officer authoriz d 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
11-00-0000