HomeMy WebLinkAbout11-0397Form 668 (Y)(c)
(Rev. February 2004)
118
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 738939911 1-
37
As provided by section 6321, 6322, and 6323 of the Internal Revenue ,
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Code, we are giving a notice that taxes (including interest and penalties) _. .- .-(
have been assessed against the following-named taxpayer. We have made Mao C- =-ri
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 r - :7j
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t
property belonging to this taxpayer for the amount of these taxes, and '
additional penalties, interest, and costs that may accrue. -
Name of Taxpayer DANA R GLEASON
C`: 8 r"t
Residence 503 FRONT ST
NEW CUMBERLND, PA 17070-2030
IMPORTANT RELEASE INFORMATION: For each assessment listed below, Ig DU ,!.
unless notice of the lien is refiled by the date given in column (e), this notice shall, P
on the day following such date, operate as a certificate of release as defined
25
2 53e ?IY
(a).
in IRC 63 /? 0
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) d) (e) M
1040 12/31/2006 XXX-XX-9065 03/15/2010 04/14/2020 11165.24
1040 12/31/2007 XXX-XX-9065 11/17/2008 12/17/2018 6057.24
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 17222.48
This notice was prepared and signed at DETROIT, MI
the 05th day of January 2011
, 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 1 - Kept By Recording Office CAT. NO 60025X