HomeMy WebLinkAbout11-0177Form 668 (Y)(c)
IRev. February 2004)
26
Department of the Treasury -Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 735393310
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
d d f nt f this liability but it remains unpaid Therefore
For Optional Use
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Office
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a eman or payme o ,
there is a lien in favor of the United States on all property and rights to ~~~ ~, '~~=s.
property belonging to this taxpayer for the amount of these taxes, and `=~ .. ^ ~ ~,
additional penalties, interest, and costs that may accrue. ~ ~ i~~
ame of Taxpayer BRIAN H &
Residence 3 9 0 BENYOU LN
NEW CUMBERLND, PA 17070-3074
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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, i9 OD /,1 ~~~~~akG~~
on the day following such date, operate as a certificate of release as defined ~ `~~tJ~~~2d+'tr'.r'
in IRC 6325(a). ~'~ o~J 3 ~3 a
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2008 XXX-XX-7069 02/08/2010 03/09./2020 2356.28
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 2356.28
This notice was prepared and signed at
the 22nd day of December
DETROIT, MI
2010
on this,
Signature ~ Title
REVENUE OFFICER 22-06-1407
for SEAN DUNLEAVY (717) 777-9626
(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) IRev. 2 2004)
Part t -Kept By Recording Office CAT. NO 60025X