HomeMy WebLinkAbout11-1029Form 668 (Y)(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
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 744865211 LTG
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 ;-1
a demand for payment of this liability, but it remains unpaid. Therefore, C=
?
there is a lien in favor of the United States on all property and rights to r
ico c. =-n
property belonging to this taxpayer for the amount of these taxes, and
:Zrtl
-a.
rrlor=
additional penalties, interest, and costs that may accrue. ;706
Name of Taxpayer KENNIE M JAMISON SR DECD ?
- =a
Cgs C-D -n
Residence 106 VIRGINIA AVE R
CARLISLE, PA 17013-1072 -- =?'
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,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
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 12/31/2008 XXX-XX-0165 06/28/2010 07/28/2020 12007.56
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 12007.56
This notice was prepared and signed at
DETROIT, MI
the 19th day of January 2011
, on this,
Signature Title
REVENUE OFFICER 22-06-1413
for LINDSEY 0 BOWLIN (717) 777-9623
(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