HomeMy WebLinkAbout10-4891Form 668 (Y)(c)
(Rev. February 2004)
11883
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 679023010
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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 Untied States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
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additional penalties, interest, and costs that may accrue. --4
Name of Taxpayer ROBERT & ALLYSON KOZENSKIE `
Residence PO BOX 53 -o
ENOLA, PA 17025-0053 y'
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
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C IRC 6325(a).
Tax Period Date of Last D for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refillng of Assessment
(a) (b) (c d) (e) (f)
1040 12/31/2001 XXX-XX-8910 07/06/2009 .08/05/2019 5767.99
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 5767.99
This notice was prepared and signed at
the 16th day of July
DETROIT, MI
2010
, on this,
Signature A 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. Rul. 71-466, 1971 - 2 C.B. 409) Form 66SM(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025X