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HomeMy WebLinkAbout11-654311883 Department of the Treasury - Internal Revenue Service Form 666 M(c) Notice of Federal Tax Lien (Rev. February 2004) A Serial Number For Optional Use by Recording Office rea: WAGE & INVESTMENT AREA #1 Lien Unit Phone: (800) 829-7650 807234311 ] l -4,5113 ?C / l ! 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 c _ "n property belonging to this taxpayer for the amount of these taxes, and additional penalties, interest, and costs that may accrue. rn Name of Taxpayer KEVIN HOLLEY Q v <a ' ©-'n Residence 154 BIG SPRING TER ?c ?' a Qc7 •' NEWVILLE, PA 17241-9112 ? CO «C 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, on the day following such date, operate as a certificate of release as defined o n I 6325(x). i 97 613y%V Tax Period Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refiling of Assessment (a) (b) (c) (d) (e) M 1040 12/31/2005 XXX-XX-8405 08/10/2009 09/09/2019 8181.37 1040 12/31/2008 XXX-XX-8405 05/25/2009 06/24/2019 780.97 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total 1 $ 8962.34 This notice was prepared and signed at DETROIT, MI the 11th day of August 2011 , on this, Signature Title zC` ACS W&I 11-00-0000 for DEBRA K. HURST (800) 829-7650 (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