HomeMy WebLinkAbout10-7635Form bb$ (Y)(c)
(Rev. February 20x41
Department of the Treasury - Inkernal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use ay Recording Office
WAGE & INVESTMENT AF2EA #1
Lien Unit Phone: (800} 829-7650
727237510
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As provided by section b321, b322, and b323 of the internai Revenue
Code, we are giving a notice that taxes (including interest and penaltiex)
have been assessed against the foilowing-named taxpayer. We have made ~ ~ -`~,~
a demand for payment of this [iabiiity, but it remains unpaid. Therefore, ~°v~ c~ --f
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 ~ ~ ~ ~rn
additional penaitiex, interest, and costs that may accrue. ~~ w Utz
Name of Taxpayer S WILLIAM SKIRBOLL ~~ -~ ~~
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Residence PO BOX 194 ~ ~
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CAMP HILL, PA 17001-0194
IMPORTANT RELEASE INFORMATION: For each assessment listed below, l /J,
unless notice of the lien is refiled by the date given in column {e), this notice shall, ~g_ pp ~(, ,~; ~
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on the day fallowing such date, operate as a certificate of release as defined
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in IRC 6325{a). ~,Sd~3G>,S
Tax Period Date of Last Dayy for Unpaid Baiance
Kind of Tax Ending Identifying Number Assessment Refi[ing of Axsessment
(a} (b) (c) (d) (e} (f}
1040 12/31/2004 XXX-XX-0602 12/21/2009 01/20/2020 47672.98
1040 12j31/2005 XXX-XX-0602 05/10/2010 06/09/2020 1430.82
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 4 910 3. 8 0
This notice was prepared and signed at
DETROIT, MI
the 02nd day of December 2010
on this,
Signature ~clZsftt` ACS 11-00-0000
far DEBRA K. HURST (80.0) 829-7650
(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. 4091
Part t -Kept gy Recording Oi~fce Farm 668(Y)(c) {Rev. 2-2004)
CAT. NO 60025X
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