HomeMy WebLinkAbout10-4889Form 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 #1
Lien Unit Phone: (800) 829-7650 679019410 lO `
? ?L
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 c?_- °
property belonging to this taxpayer for the amount of these taxes, and -77 f'- 7-Z!
additional penalties, interest, and costs that may accrue. 7
Name of Taxpayer CAROLE F CHENEY
Residence 213 S 18TH ST y _ r~
CAMP HILL, PA 17011-5514
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refilled by the date given in column (e), this notice shall, I(? .DD cJ?P?trti
on the day following such date, operate as a certificate of release as defined
i
IRC 6 225(
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7
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a
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a
02
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a b) c d (e)
1040 12/31/2008 XXX-XX-7624 06/01/2009 07/01/2019 1265.91
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
the 16th day of July
Total J$ 12 6 5.91
DETROIT, MI
2010
, on this,
Signature A 'Y-h? Title
ACS 11-00-0000
for DEBRA K. HURST (800) 829-7650
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rut. 71-466,1971 - 2 C.B. 409)
Part I - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X