HomeMy WebLinkAbout11-7653Form 668 M(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA 42
Lien Unit Phone: (800) 913-6050
For Optional Use
815398611 7
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A. 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
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer
Residence 9 TRINE AVE
MOUNT HOLLY SPRINGS, PA 17065-1144
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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, ?Cj
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). _2 677 41-;-119
Office
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 12/31/2003 XXX-XX-7914 09/05/2011 10/05/2021 3371.43
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 3371.43
This notice was prepared and signed at
the 19th day of September
DETROIT, MI
2011
, on this,
Signature Title
REVENUE OFFICER 22-06-1413
for LINDSEY 0 BOWLIN -4% (717) 777-9623
(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(7)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X