HomeMy WebLinkAbout10-6958Form 668 (Y)(c)
(Rev. February 2004)
1188
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 713196210
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 w'°
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additional penalties, interest, and costs that may accrue. 4 ?
Name of Taxpayer CENTRAL PENNSYLVANIA PULMONARY
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CD
ASSOCIATES LLC CLARK TIMOTHY A SOLE ME MBER
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Residence 2250 MILLENNIUM WAY
ENOLA, PA 17025-1488
IM
TANT RELEASE INFORMATION: For each assessment listed below,
unlotice of the lien is refiled by the date given in column (e), this notice shall,
:
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on day following such date, operate as a certificate of release as defined
in I325(a).
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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
1 03/31/2010 56-2382216 10/11/2010 11/10/2020 116324.28
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total J$ 116324.28
This notice was prepared and signed at
the 26th day of October
DETROIT, MI
2010
, on this,
Signature Title
REVENUE OFFICER 22-06-1441
for DENNIS P ZMUDZIN (717) 777-9624
(NOTE: Certificate of officer authorized by law to take acknowledgment is riot essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466,1971 - 2 C.B. 409) Part 1 - Kept By Recording Office CAT. b6$( 1Rev. 2 2004?
CAT. NO 60025X
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