HomeMy WebLinkAbout11-4179Form 668 MW
(Rev. February 2004)
1883
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 781030511
79
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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
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 rnX
additional penalties, interest, and costs that may accrue. =
Name of Taxpayer PATRICK K MYERS
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Residence 518 KATRINA CT
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MECHANICSBURG, PA 17050-8702 ??
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NT RELEASE INFORMATION: For each assessment listed below,
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unless e of the lien is refiled by the date given in column (e), this notice shall,
:
on the following su ch date, operate as a certificate of release as defined
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in IRC 5(a). o? s? CJ'?3
Tax Period Date of Last Day for
n Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refil
g of Assessment
(a) (b) (c) (d) (e) (f)
CIVP 12/31/2008 XXX-XX-9683 09/21/2009 10/21/201.9 39054.12
CIVP 03/31/2009 XXX-XX-9683 10/04/2010 1.1./03/2020 45133.04
CIVP 06/30/2009 XXX-XX-9683 10/04/2010 11/03/2020 11192.04
CIVP 09/30/2009 XXX-XX-9683 10/04/2010 11/03/2020 16991.30
CIVP 12/31/2009 XXX-XX-9683 10/04/2010 11/03/2020 24502.81
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total I$ 136873.31
This notice was prepared and signed at DETROIT, MI
the 28th day of April 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) Part 1 - Kept By Recording Office CAT. 668( (Rev. 2-2004)
CAT. NO 60025X
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