HomeMy WebLinkAbout10-7701Form bb8 (Y)(c)
(Rev. February 20041
883
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? 829-3903 728905410
As provided by section b321, b322, and 6323 of the Internal Revenue ,/~ " ~ 7r7 r .~~ ~L o
we are giving a notice that taxes (including interest and penalties)
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have been assessed against the following-named taxpayer. We have made ~~c ~ rn~
a demand for payment of this liability, but it remains unpaid. Therefore, .~-~. ~ c ~ .,or-
there is a lien in favor of the united States on all property and rights to ir3 r- _ ~~~-
property belonging to this taxpayer for the amount of these taxes, and --t; ~: r ~~
additional penalties, interest, and costs that may accrue. ~ p ~ ~
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Name of Taxpayer JOHN W & RACHELLE D DAVIDSON .~==~
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Residence 6 DYKEMAN RD ~ ~
SHIPPENSBURG, PA 17257-8701
IMPORTANT RELEASE INFORMATION: For each assessment listed below, ~/l,D~ ~,
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unless notice of the lien is refiled by the date given in column (e), this notice shall, ..
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on the day following such date, operate as a certificate of release as defined
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Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) {b) (c) (dj (e) (f)
1040 12/31/2009 XXX-XX-2168 07/26/2010 08/25/2020 2362.70
Place of Filing
Prathanotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 2362.70
This notice was prepared and signed at
DETROIT, MI
the 07th 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.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part l -Kept By Retarding Of17ce CAT. NO 60025X