HomeMy WebLinkAbout10-5036Form 668 (Y)(c)
(Rev. February 2004)
3866
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 680848410 7-'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
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer KIM A SULTZBAUGH
AKA KIM A HILEMAN 7 -TI
7
Residence 806 BRIARWOOD LN
CAMP HILL, PA 17011-1513
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, /9,00
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on the day following such date, operate as a certificate of release as defined
o r?ra s
i
n I 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2004 XXX-XX-9632 11/03/2008 12/03/2018
1040 12/31/2004 XXX-XX-9632 06/29/2009 07/29/2019 5482.30
1040 12/31/2005 XXX-XX-9632 10/27/2008 11/26/2018 6476.93
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 11959.23
This notice was prepared and signed at
the 22nd day of July
DETROIT, MI
2010
, on this,
Signature A yk,I,LQQ 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 668(Y)(c) (Rev. 2-2004)
Part 2 - Internal Revenue Service TDA Copy CAT. NO 60025X
L40'
Form 668 (Z) 3619 Department of the Treasury - Internal Revenue Service
(Rev. 10-20W) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 1 680848410
1 certify that the following-named taxpayer,under the requirements of section 6325(a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and C) P-1
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on August 02 CD D-
2010 , is authorized to note the books to show the release of this lien for
these taxes and additions.
Ul
Name of Taxpayer
KIM A SULTZBAUGH 1P,C-,
AKA KIM A HILEMAN c'
CAMP HILL, PA 17011-1513
COURT RECORDING INFORMATION: P,-/
Liber Page UCC No. Serial No.
Tax Period Pat*Of Last Day for Unpaid Bafance
Kind of Tax Ending Identfifying Number Assessment Refiflng of Assessment
1040 12/31/2004 XXX-XX-9632 11/03/2008 12/03/2018
1040 12/31/2004 XXX-XX-9632 06/29/2009 07/29/2019 5482 .30
1040 12/31/2005 XXX-XX-9632 10/27/2008 11/26/2018 6476 . 93
Place of Filing
Prothonotary
Cumberland County Total $ 11959.23
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 27th day of March , 20I3 .
Signature Title
Operations Manager,
lCentralized Case Processing-Lien Unit
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Part I -RECORDING OFRCE CAT. NO 600261