HomeMy WebLinkAbout10-7316Form 668 (Y)(c)
IRev. Fehruary 20041
883
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Retarding Office
SMALL BUSINESSjSELF EMPLOYED AREA #2
Lien Unit Phone: (800? 913-6050 721256010
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As provided by section b321, 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, n
there is a lien in favor of the united States on all property and rights to „~3 ~ ~ _
property belonging to this taxpayer for the amount of these taxes, and t*t~
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additional penalties, interest, and costs that may accrue. Z~ ,~ ~r
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Name of Taxpayer CENTRAL PENNSYLVANIA PULMONARY ~A ~ ~d
ASSOCIATES LLC CLARK TIMOTHY A SOLE ME BER ,C
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Residence 2250 MILLENIUM WAY STE 400 3
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ENOLA , PA 17 0 2 5 -14 8 8 .,,,{ ,~ s,
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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, ~c
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on the day following such date, operate as a certificate of release as defined
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IRC 6325(
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Tax Period Date of Last D for
~ Vet~-aid Balance
Kind of Tax Ending Identifying Number Assessment Refi
ng of Assessment
(a) (b) (c) (d (e) (f
941 06/30/2010 56-2382216 11/01/2010 .12/01/2020 99218.98
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 99218.98
This notice was prepared and signed at DETROIT, MI
the 15th day of November 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 not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, t 971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-20041
Part t -Kept ey Recording Office CAT. NO 60025X
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