HomeMy WebLinkAbout10-5039Form 668 (Y)(c)
(Rev. February 2004)
3
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 680914410
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 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 777
additional penalties, interest, and costs that may accrue. `? ' -
Name of Taxpayer JAMES G JOHNSON
N,
-
Residence 36 CAVALRY RD °.
CARLISLE, PA 17013-1601
ASE INFORMATION: For each assessment listed below,
n is refiled by the date given in column (e), this notice shall,
= 19.00
such date, operate as a certificate of release as defined
6325(a). y?
A'" ayG I/7
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Day for
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2009 XXX-XX-2874 06/14/2010 07/14/2020 515.41.
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
2010
This notice was prepared and signed at
the
Signature Title
REVENUE OFFICER 22-06-1407
for SEAN DUNLEAVY (717) 777-9626
22nd day of July
DETROIT, MI
Total 1 $ 515.41
, on this,
4.41
iknvm c: %-erTiTicaie or otticer 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 Form 668(Y)(c) (Rev. 2-2004)
By Recording Office CAT. NO 60025X