HomeMy WebLinkAbout10-5043Form 668 (Y)(c)
(Rev. February 20041
386
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 681576310 16 _ ,_,_"3 ff ?L
S (?f
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 c7
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 v `
property belonging to this taxpayer for the amount of these taxes, and -
additional penalties, Interest, and. costs that may accrue. gl fU -
Name of Taxpayer DANIELLE M BARNES y, 7- 1
Residence
304 DEANHURST AVE
.?
CAMP HILL, PA 17011-5315
TANT RELEASE INFORMATION: For each assessment listed below,
otice of the lien is refiled by the date given in column (e), this notice shall,
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t9 ?O `?
day following such date, operate as a certificate of release as defined
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i
nl
325(a).
TaxPeriod Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c (d) e) (f)
1.040 12/31/2004 XXX-XX-4028 05/04/2009 06/03/2019 9526.32
6672 06/30/2007 XXX-XX-4028 03/31/2008 04/30/2018 43501.95
6672 09/30/2007 XXX-XX-4028 12/28/2009 01/27/2020 16955.98
6672 06/30/2008 XXX-XX-4028 12/28/2009 01/27/2020 27369.64
6672 09/30/2008 XXX-XX-4028 12/28/2009 01/27/2020 66303.18
6672 12/31/2008 XXX-XX-4028 12/28/2009 01/27/2020 49490.61
6672 03/31/2009 XXX-XX-4028 12/28/2009 01/27/2020 45002.60
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 258150.28
This notice was prepared and signed at DETROIT, MI
the 23rd day of July 2010.
, on this,
Signature f? fiyhaF/? REVtle
ENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
W .A/
(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 1 - Kept By Recording Office CAT. NO 60025X