HomeMy WebLinkAbout11-8351 Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
Notice of Federal Tax Lien
Mew. February 2004)
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 82488681.1
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,,)
there is a lien in favor of the United States on all property and rights to 3 ---"4
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property belonging to this taxpayer for the amount of these taxes, and rncD -S r
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additional penalties, interest, and costs that may accrue. r-
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Name of Taxpayer BRYON L FERTENBAUGH "<? t O
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Residence 1105 COPPER CREEK DR DZ _ DM
MECHANICSBURG, PA 1.705()-1-964 a ::0
IMPORTANT RELEASE INFORMATION: For each a ,s. s e;rt ,f r1) !? ,
f the lien is refiled by the date given in column er !;'i
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ess no
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or) the day following such date, operate as a certificate of raiease as defined
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IRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
(Kind of Tax Ending Identifying Number Assessment I Refiling of Assessment
(a) (b) (c) (d) (e) M -
1040 12/31/2003 XXX-XX-7790 03/02;`04/01/2019 10497.56
1040 12/31/2004 XXX-XX-7790 03,/0'7,'/2009' 04/01/2019 13434.97
1040 12/31/2005 XXX-XX-7790 030-/23 ,091 04/01/201-9 8020.75
1.040 12/31/2006 XXX-XX-7790 1 03/02,!20091 04/01/203-9 14962.42
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Place of Filing
Prothonotary
Cumberland County Total ? 46915.70
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, M' _ on this,
the 28th day of October 2011
Signature r 7"t'`'
A ' c r3 ,per 22-00-0001,
d80 s
£j :? => '19 t) 3
for FRED BANKS 1v/ ? 3 0 t; ; 8
(NOTE: Certificate of officer authorized by law to take acknowledgmert 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 I - Kept By Recording Office CAT. NO 60025X