HomeMy WebLinkAbout11-0410Form 668 (Y)(c)
(Rev. February 2004)
11883
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 739489011
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 ? 5
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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
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. -~7
Name of Taxpayer GARY A MICULITA JR
Residence 2458 LOBACH DR
MECHANICSBURG, PA 17055-5376
IMORTANT RELEASE INFORMATION: For each assessment listed below,
P
unls notice of the lien is refiled by the date given in column (e), this notice shall, ~4-
on the day following such date, operate as a certificate of release as defined
o
n I 6325(a).
i a S 3 fS 7
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Reflling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-4884 10/12/2009 11/11/2019 2296.55
1040 12/31/2006 XXX-XX-4884 10/12/2009 11/11/2019 2853.28
1040 12/31/2008 XXX-XX-4884 06/01/2009 07/01/2019 335.89
1040 12/31/2009 XXX-XX-4884 06/14/2010 07/14/2020 3860.02
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 9345.74
This notice was prepared and signed at
the 06th day of January
DETROIT, MI
2011
, on this,
Signature Title
cc` 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
Y/