HomeMy WebLinkAbout11-8120Form 668 (Y)(c)
(Rev. February 2004)
118
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 #7
Lien Unit Phone: (800) 913-6050 820567911
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 .
a demand for payment of this liability, but it remains unpaid. Therefore, 4
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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.
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Name of Taxpayer MARK A MILLER ', w
Residence 111 BRIDGE ST APT 7
NEW CUMBERLND, PA 17070 -`
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
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s refiled by the date given in column (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). yl ?, G 3(,, ?-
Kind of Tax Tax Period
Ending
identifying Number Date of
Assessment Last Day for
Refilling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2003 XXX-XX-5335 06/07/2004 07/07/2014 1725.92
1040 12/31/2004 XXX-XX-5335 05/30/2005 06/29/2015 1753.25
1040 12/31/2005 XXX-XX-5335 10/01/2007 10/31/2017 2882.76
1040 12/31/2006 XXX-XX-5335 06/04/2007 07/04/2017 1424.93
1040 12/31/2007 XXX-XX-5335 04/25/2011 05/25/2021 4066.15
1040 12/31/2008 XXX-XX-5335 04/18/2011 05/18/2021 2737.53
1040 12/31/2009 XXX-XX-5335 04/18/2011 05/18/2021 2943.33
1040 12/31/2010 XXX-XX-5335 05/30/2011 06/29/2021 758.56
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 18292.43
This notice was prepared and signed at DETROIT, MI
the 12th day of October 2011
, on this,
Signature Title
-1 ACS W&I 11-00-0000
for DEBRA K. HURST -4!?* 1 (800) 829-7650
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(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 Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X