HomeMy WebLinkAbout04-3359Form 668 (Y)(c)
{Rev. February 2004)
Area: I Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (S00) 829-3903 178359104
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 os= this liability, but it remains unpaid. Therefore,
there is a lien in favor oS= the United States on all property and rights to
property belonging to this taxpayer S=or the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Neme of Texpeyer ~TIC C DAS$
Residence
1008
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optional Use by Recording Office
PO BOX 245
ENOLA, PA 17025-0245
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
Kind of Tax Ending Identifying Number Assessment Retiring
(a) (b) (c) (d) (e)
1040 12/31/2002 208-42-2609 10/27/2003 11/26/2013
Unpaid Balance
of Assessment
(f)
3323.36
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 3323.36
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 23rd day of June 2004
Signa "~ - ~..~ Title
/~,,~, x~ju~_~ ~' ~ ACS
for L LEDER (800)
829-3903
23-00-0008
(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 ~'&8(¥)(¢) (Rev. 2 2004)
Part I - Kept By Recording Office CAT. NO 60025X