HomeMy WebLinkAbout10-6431Form 668 M(c)
(Rev. February 20041
36.21
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 705673910
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 JUSTIN MATTHEW KELLY
STUDIO 3 HAIR DESIGN
Residence 1412 A TRINDLE ROAD
CARLISLE, PA 17015-8538
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
in IRC 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)
941 03/31/2009 20-1369122 08/16/2010 09/15/2020 3713.98
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
DETROIT, MI
This notice was prepared and signed at
For Optional Use by Recording Uttice
MW
ril C=)
C-)
-
O r
? C:2
c-i 1:20
M C) -n
=---
Zc:) c)?
/g_ oOPd- Az?~4
aq9 y-7r
Total. 1 $ 3713.98
on this,
the 30th day of September 2010
Signature -I Title
?• REVENUE OFFICER 22-06-1413
for LINDSEY O BOWLIN (717) 777-9623
(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 i - Kept By Recording Office CAT. NO 60025X