HomeMy WebLinkAbout11-0404Form 668 M(c)
(Rev. February 2004)
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 739464111
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 «s
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 =M '
property belonging to this taxpayer for the amount of these taxes, and r- 7
-
additional penalties, interest, and costs that may accrue. -
--c ,° 70 C
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Name of Taxpayer LEROY E FREY -r
Residence 2 514 ROLO CT
MECHANICSBURG, PA 17055-5898
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
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following such date, operate as a certificate of release as defined
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(a).
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Tax Period Dateof Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2002 XXX-XX-0480 09/05/2005 10/05/2015 57065.87
1040 12/31/2004 XXX-XX-0480 04/30/2007 05/30/2017 64194.74
1040 12/31/2005 XXX-XX-0480 01/11/2010 02/10/2020 90961.21
1040 12/31/2006 XXX-XX-0480 01/11/2010 02/10/2020 79952.98
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 292174.80
This notice was prepared and signed at
the 06th day of January
DETROIT, MI
2011
, on this,
Signature _ Title
ACS 11-00-0000
for DEBRA K. HURST Z-?Vq (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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