HomeMy WebLinkAbout11-3683Form 668 (Y)(c)
(Rev. February 2004)
5226
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
772388411
As provided by section 6321, 6322, and 6323 of the Internal Revenue 91/9,6U P'-L F.7'
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, n
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 rquo =0
additional penalties, interest, and costs that may accrue. ? ? =
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Name of Taxpayer JAY M WAY -C Z;
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Residence 1237 YORK RD
MECHANICSBURG, PA 17055-9769
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 Re filing of Assessment
(a) (b) (c) (d) ( e) M
1040 12/31/2002 XXX-XX-4835 09/29/2008 10/29/2018 10574.00
1040 12/31/2009 XXX-XX-4835 05/31/2010 06/30/2020 689.22
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 11263.22
This notice was prepared and signed at DETROIT, MI
the 01st day of April 2011
, on this,
Signature Title
ACS W&I 11-00-0000
for DEBRA K. HURST --4*z-7?4 (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