HomeMy WebLinkAbout10-4734Form 668 (Y)(O
(Rev. February 2004)
11883
Department of the Treasury - Internal Revenue Service
Notice of Federal Tau Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 668403110
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 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.
ame of Taxpayer
Residence 925 SPRING CIR
MECHANICSBURG, PA 17055-4055
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,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Dar?rr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Reeling of Assessment
(a) (b c) d e M
1040 12/31/2002 XXX-XX-4550 11/28/2005 12/28/2015 35015.71
1040 12/31/2003 XXX-XX-4550 07/23/2007 08/22/2017 74520.92
1040 12/31/2004 XXX-XX-4550 07/23/2007 08/22/2017 35078.24
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
the 17th day of June
DETROIT, MI
For Ootional Use by Recording Office
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Total 1 $ 144614.87
, on this,
2010
Signature
22-00-0008
7-? A ACS tle
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 Ofto CAT. NO 60025X