HomeMy WebLinkAbout11-6034Form 668 (Y)(c)
(Rev. February 2004)
26
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 802170511
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 r4,
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 3 `
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property belonging to this taxpayer for the amount of these taxes, and rna
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penalties, interest, and costs that may accrue.
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Name of Taxpayer SABOOR A MOHMAND Q
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Residence
817 MEADOW LN C
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CAMP HILL, PA 17011-1546 71
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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,
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on the day following such date, operate as a certificate of release as defined 7 f
in IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2003 XXX-XX-3829 03/07/2005 04/06/2015 623.75
1040 12/31/2004 XXX-XX-3829 01/05/2009 02/04/2019 14934.32
1040 12/31/2005 XXX-XX-3829 08/16/2010 09/15/2020 32546.87
1040 12/31/2006 XXX-XX-3829 06/01/2009 07/01/2019 13518.06
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 61623.00
This notice was prepared and signed at DETROIT, MI
the 21st day of July 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) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X