HomeMy WebLinkAbout10-4890Form 668 (Y)(c)
(Rev. February 2004)
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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 679019510 0 -qGDTL
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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. n
Name of Taxpayer CAROLE F & GLEN CHENEY
t
Residence 213 S 18TH ST
al
CAMP HILL, PA 17011-5514
IMPONT RELEASE INFORMATION: For each assessment listed below, '`.
unlesS: e of the lien is refiled by the date given in column (e), this notice shall, `9 ¢
on thfollowing such date, operate as a certificate of release as defined
on
IRC 5(a). 1 V-d 91
Tax Period Date of Last D for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) b) c) d e)
1040 12/31/2004 XXX-XX-7624 05/01/2006 05/31/2016 7548.17
1040 12/31/2005 XXX-XX-7624 05/29/2006 06/28/2016 1277.22
1040 12/31/2007 XXX-XX-7624 04/21/2008 05/21/2018 1236.31
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total J$ 10061.70
This notice was prepared and signed at DETROIT, MI
the 16th day of July 2010
, on this,
Signature ?.- A -Y ? 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 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X