HomeMy WebLinkAbout11-0174Form 668 (Y)(c)
(Rev. February 2004)
5226
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 734708510 I~ _ ~~
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s 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 of this liability, but it remains unpaid. Therefore, ~~'~ "'~'
there is a lien in favor of the United States on all property and rights to .w ~, = ~.-~
property belonging to this taxpayer for the amount of these taxes, and s- ~ '~ F=-
additional penalties, interest, and costs that may accrue. ~
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Name of Taxpayer ROBERT H BRUETSCH "' ~ d u:e
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Residence 4735 SEARS RUN DR =
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MECHANICSBURG, PA 17050-2562 _
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IMPORTANT RELEASE INFORMATION: For each assessment listed below
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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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in IRC 63251a1.
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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) (d) (e) (17
1040 12/31/2004 XXX-XX-5056 12/08/2008 _01/07/2019 8498.54
1040 12/31/2005 XXX-XX-5056 12/08/2008 01/07/2019 9271.93
1040 12/31/2006 XXX-XX-5056 04/20/2009 05/20/2019 4226.47
1040 12/31/2007 XXX-XX-5056 04/12/2010 05/12/2020 10367.83
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 32364.77
This notice was prepared and signed at
DETROIT, MI
the 21st day of December 2010
on this,
Signature ~~~ Title
ACS 11-00-0000
for DEBRA K. HURST (800) 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. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025X
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