HomeMy WebLinkAbout11-7651Form 668 (Y)(c)
IRev. 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 818115811 /
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1
As provided by section 6321, 6322, and 6323 of the Internal Revenue ! 7??/ r
7
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
property belonging to this taxpayer for the amount of these taxes, and w o
additional penalties, interest, and costs that may accrue. W
M ? _-•a r°
Name of Taxpayer DAVID E RIFE
Residence
7 E GREEN ST
4 •K-?, ;•-;
SHIREMANSTOWN, PA 17011-6551
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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, I??? )??
on the day following such date, operate as a certificate of release as defined f
in IRC 3325(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) (f)
1040 12/31/2004 XXX-XX-1764 04/18/2011 05/18/2021 8588.52
1040 12/31/2008 XXX-XX-1764 03/07/2011 04/06/2021 6673.74
1040 12/31/2009 XXX-XX-1764 04/25/2011 05/25/2021 6573.91
1040 12/31/2010 XXX-XX-1764 05/30/2011 06/29/2021 4574.35
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 26410.52
This notice was prepared and signed at
DETROIT, MI
the 30th day of September 2011
, on this,
Signature Title
qtr` 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)
Part 1 - Kept By Recording Office CAT. 668( (Rev. 2 2004)
CAT. NO 60025X