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Department of the Treasury - Internal Revenue Service
F°r." 668 (Y)(`)
(Rev. February 20041 Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #5
Lien Unit Phone: (800) 913-6050 669453710 /D -Y73 r7 -
,
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 foliowing-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 n
(77-
additional penalties, interest, and costs that may accrue.
-
Name of Taxpayer JOHN S FULTON ;
Residence 721 2ND STREET
NEW CUMBERLAND, PA 17070
0 ELEASE INFORMATION: For each assessment listed below, , c
he lien is refiled by the date given in column (e), this notice shall,
=
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wing such date, operate as a certificate of release as defined
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1RC6325
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. a115
Tax Period Date of Last Dayfor Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a b) c d (e) M
6672 09/30/2006 XXX-XX-3709 09/28/2009 10/28/2019 437.46
6672 12/31/2006 XXX-XX-3709 09/28/2009 10/28/2019 4676.48
6672 03/31/2007 XXX-XX-3709 09/28/2009 10/28/2019 9500.85
6672 06/30/2007 XXX-XX-3709 09/28/2009 10/28/2019 2075.94
6672 09/30/2007 XXX-XX-3709 09/28/2009 10/28/2019 6625.40
6672 12/31/2007 XXX-XX-3709 09/28/2009 10/28/2019 5145.80
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 28461.93
This notice was prepared and signed at
the 18th day of June
DETROIT, MI
2010
, on this,
Signature -T-? A \'Y? Title
REVENUE OFFICER 25-15-3246
for JOSEPH KENNEDY (404) 338-9276
(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. 2-2004)
CAT. NO 60025X
X