HomeMy WebLinkAbout10-7641Form b68 (Y)(c)
(Rev. February 2b04)
11883
gepartment of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BTJSINESS/SELF EMPLOXED AREA #2
Lien Unit Phone: (800) 829-3903 727993410
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As provided by section 6321, 6322, and b323 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 "~~ o` ~
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additional penalties, interest, and costs that may accrue. ~~ ~ ~
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Name of Taxpayer DENNIS P SHAX ~~ -- ~7p
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Residence
5165 E TRINDLE APT A ~
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MECHANICSBURG, PA 17050-3624 ~"'" ~ ~`~
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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, ;~
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ifi of release as defined
on the day fallowing such date, operate as a cert sate G
in IRC 6325(a). ~ ~ a ~/
Tax Period Date of Last Dayy for l[npaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) {e) (f)
1040 12/31/2002 XXX-XX-4372 11/24/2003 12/24/2013 2251.19
1040 12/31/2004 XXX-XX-4372 04/20/2009 05/20/2019 11166.51
1040 12/31/2005 XXX-XX-4372 04/20/2009 05/20/2019 11245.47
1040 12/31/2007 XXX-XX-4372 04/12/2010 05/12/2020 7930.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 32593.92
This notice was prepared and signed at .` DETROIT, MI
the 03rd day of
December 2010
on this,
Signature Title
_ ~~ ACS 22-00-0001
for FRED BANKS {800) 829-3903
(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.6. 4091
Part t -Kept gy Recording Oftlce Form bb8(Y)(c) (Rev. 2-20041
CAT. NO 60025X
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