HomeMy WebLinkAbout01-3035 I 499 Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
IRsv. October 2000)
Area: I Serial Number For Optional Use by Recording Office
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are slvin~ a notice that taxes (including interest and penalties)
have been assessed against the followins-named taxpayer. We have made
a demand for payment of chis liability, but it remains unpeld. Therefore,
there b a lien in favor of the United States on all property and rights to
property belon&4ns to this taxpayer for the amount of thru taxes, and c:- :?._' ..~
additional penalties, interest, and costs that may accrue. -~,, .~.
Hame of Taxpayer JEFFREY D
Residence 345 GETTYSBURG PIKE :.':...;'. ''..
MECHANICSBURG, PA 17055-5171 i'.- ;::: ''
IMPORTAHT PJ:LF-4kSI INFOPJ'IATION: For eech essessme~t listed below, -,~
unless notice of the lien is refiled by the date given in column lei, this notice shall,
in°n the day following such date, operate as a certificate of release as definediRc 6325(a).
Tax Period Date of Last Day for Unpaid BaLance
Kind of Tax Endhg IdentlfJdng Number Assessment ReHHng of Assessment
1040 12/31/1995 162-48-2443 09/16/1996 10/16/2006 2657.56
1040 12/31/1996 162-48-2443 05/19/1997 06/18/2007 3118.18
1040 12/31/1997 162-48-2443 07/06/1998 08/05/2008 3155.56
PlaceofFiling
Prothonotary Total $
Cumberland County 8931.30
Carlisle, PA 17013
This notice was prepared and signed at PITTSBURGH, PA , on this,
the 08th day of May 2001
Signature I Title
ACS 23-01-0008
for L G DOWD (800) 829-3903
(~IOT~: 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.6. 409) Form &&8(Y)(¢) (Rev. 10-00)
Part I - Kept By Recording Office CAT. NO 60025X