HomeMy WebLinkAbout11-6844Form 668 M(c)
(Rev. February 2004)
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 809773911
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As provided by section 6321, 6322, and 6323 of the
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made n
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 ?m c rnF
property belonging to this taxpayer for the amount of these taxes, and aM ? -urn
additional penalties, interest, and costs that may accrue. <> - o?
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Name of Taxpayer DAVID BERRIOS
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Residence 611 HERMAN AVE # 2D .< tit
LEMOYNE, PA 17043-1824
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 P
in IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2007 XXX-XX-8763 06/27/2011 07/27/2021 1698.28
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 1698.28
This notice was prepared and signed at
the 23rd day of August
DETROIT, MI
2011
, on this,
Signature Title
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)
Form 668( (Rev. )
Part 1 - Kept By Recording Office CAT. NO 60025X
025X
CAT