HomeMy WebLinkAbout11-4554Form 668 MW
(Rev. February 2004)
11883
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 786126211
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 c -rt
a demand for payment of this liability, but it remains unpaid. Therefore, 3 -?
there is a lien in favor of the United States on all property and rights to
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property belonging to this taxpayer for the amount of these taxes, and -or"
additional penalties, interest, and costs that may accrue. tnr? XlM l=
Name of Taxpayer SHIPPENSBURG TRAVEL CENTER INC ZL,,
a Corporation MR
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3rd Q
Residence
15 HERSHEY RD .i --
SHIPPENSBURG, PA 17257-9407
RTANT RELEASE INFORMATION: For each assessment listed below,
notice of the lien is refiled by the date given in column (e), this notice shall,
day followin
such date
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6325(a). J;--IF7- ORSY4,60
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)
940 12/31/2010 26-1547127 04/25/2011 05/25/2021 1057.51
944 12/31/2010 26-1547127 05/02/2011 06/01/2021 6251.23
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 7308.74
This notice was prepared and signed at DETROIT, MI
the 16th day of May 2011
, on this,
Signature Title
c` REVENUE OFFICER 22-06-1408
for MIGNA RODRIGUEZ _4* (717) 777-9622
e4ft
(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 Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X