HomeMy WebLinkAbout11-0424Form 668 (Y)(c)
(Rev. February 2004)
11
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 740317211 r
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 -
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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 -cY" -- r a
additional penalties, interest, and costs that may accrue. fi `D
Name of Taxpayer ROBERT J SHAY
Residence 319 GEARY AVE
NEW CUMBERLND, PA 17070-1854
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,
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on the day following such date, operate as a certificate of release as defined
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in IRC 6325(a). oZs 5- 6 7
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-2701 10/19/2009 11/18/2019 66062.15-
1040 12/31/2006 XXX-XX-2701 10/19/2009 11/18/2019 21985.38
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 88047.53
This notice was prepared and signed at DETROIT, MI
the 07th 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