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HomeMy WebLinkAbout11-5321Form 668 (Y)(c) (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 794882011 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, C a -11 there is a lien in favor of the United States on all property and rights to -a3 = -4 property belonging to this taxpayer for the amount of these taxes, and Zrn .?,? additional penalties, interest, and costs that may accrue. Name of Taxpayer JEFFREY W ROSEWEIR ma) O <? Z Residence 1335 WINDSOR RD T+ ? drrTrt MECHANICSBURG, PA 17050-6625 -c ©' -C ORTANT RELEASE INFORMATION: For each assessment listed below , ss notice of the lien is refiled by the date given in column (e), this notice shall, F )0 he day following such date, operate as a certificate of release as defined o RC 6325(a). in jet * G??3 Tax Period Date of Last Dayy for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refiling of Assessment (a) (b) (c) (d) (e) (f) 6672 06/30/2007 XXX-XX-8499 03/23/2011 04/22/2021 10876.58 6672 09/30/2007 XXX-XX-8499 03/23/2011 04/22/2021 2580.86 6672 12/31/2007 XXX-XX-8499 03/23/2011 04/22/2021 5539.11 6672 03/31/2008 XXX-XX-8499 03/23/2011 04/22/2021 6421.70 6672 06/30/2008 XXX-XX-8499 03/23/2011 04/22/2021 4478.97 6672 09/30/2008 XXX-XX-8499 03/23/2011 04/22/2021 6693.29 6672 12/31/2008 XXX-XX-8499 03/23/2011 04/22/2021 130.09 6672 03/31/2009 XXX-XX-8499 03/23/2011 04/22/2021 4107.68 6672 06/30/2009 XXX-XX-8499 03/23/2011 04/22/2021 4107.68 6672 09/30/2009 XXX-XX-8499 03/23/2011 04/22/2021 4107.68 6672 12/31/2009 XXX-XX-8499 03/23/2011 04/22/2021 4107.68 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total 1 $ 53151.32 This notice was prepared and signed at the 21st day of June DETROIT, MI 2011 , on this, Signature Title mac` REVENUE OFFICER 22-06-2143 for DAVID L KUBIK (724) 720-2016 (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