HomeMy WebLinkAbout11-7062Form 668 (Y)(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
:
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 811835211
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
payment of this liability, but it remains unpaid. Therefore,
a demand for
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there is a lien in favor of the United States on all property and rights to M G0 - _,
property belonging to this taxpayer for the amount of these taxes, and zM rn
additional penalties, interest, and costs that may accrue. n
Name of Taxpayer JEFFREY H CONZ r'j
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Residence 213 1ST ST BOX 143 ?? ?r i
SUMMERDALE, PA 17093-8021 N
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, I(j, ?? ?, L%. T
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). C7y
Tax Period Date of Last Darr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2007 XXX-XX-3916 03/21/2011 04/20/2021 25311.46
1040 12/31/2008 XXX-XX-3916 03/21/2011 04/20/2021 4722.71
Place of Filing
Total $ 30034.17
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
the 01st day of September 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) Part 1 - Kept By Recording Office CAT. 668( (Rev. 2-2004)
CAT. NO 60025X
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