HomeMy WebLinkAbout11-7608Form 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) 829-3903 815152811
As provided by section 6321, 6322, and 6323 of the Internal Revenue 1 - ?7(0? ?? L"
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 _
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property
belonging to this taxpayer for the amount of these taxes, and ''? l
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additional penalties, interest, and costs that may accrue. tom-
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Name of Taxpayer DUSTIN L PALMER "? -
Residence 202 OLD YORK RD APT B t"
NEW CUMBERLND, PA 17070-3402 ?r1
-
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
in IRC 6325(a). PA4 6)
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Re8U of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2007 XXX-XX-4235 12/13/2010 01/12/2021 19846.99
1040 12/31/2009 XXX-XX-4235 03/28/2011 04/27/2021 2698.93
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 22545.92
This notice was prepared and signed at
the 16th day of
DETROIT, MI
September 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