HomeMy WebLinkAbout11-2057Form 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) 829-3903 752657811
As provided by section 6321, 6322, and 6323 of the Internal Revenue j " oZOS f
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
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 . 3: ---?
property belonging to this taxpayer for the amount of these taxes, and rn ; - -n
additional penalties, Interest, and costs that may accrue. cis
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Name of Taxpayer JEFFREY D & JOANNA POLLAK C
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Residence 5020 E TRINDLE RD
MECHANICSBURG, PA 17050-3621
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). o-2f 5V 31
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-4142 02/08/2010 03/09/2020 20571.91
1040 12/31/2006 XXX-XX-4142 12/28/2009 01/27/2020 19086.69
1040 12/31/2007 XXX-XX-4142 12/21/2009 01/20/2020 15646.78
1040 12/31/2008 XXX-XX-4142 12/21/2009 01/20/2020 11055.46
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 66360.84
This notice was prepared and signed at DETROIT, MI
the - 10th day of February 2011.
, on this,
Signature Title
ACS SBSE 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
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