HomeMy WebLinkAbout11-9525 Form 668 (Z) 11883 Department of the Treasury - Internal Revenue Service
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 837375511
I certify that the following-named taxpayer,under the requirements of section 6325 (a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on December 28 Cr _C=
2011 , is authorized to note the books to show the release of this lien for
these taxes and additions. rn -0 rn
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Name of Taxpayers =�
HERBERT M & CHERYL D SMITH r-XX �p
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Residence 518 BRIGHTON PL rri
MECHANICSBURG PA 17055-5483
COURT RECORDING INFORMATION: -j
Liber Page UCC No. Serial No.
n/a n/a n/a 2011-09525 y'7/j-
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2009 XXX-XX-6874 06/28/2010 07/28/2020 33357 . 68
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County Total $ 33357 . 68
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 17th day of April 2013
Signature Title
Operations Manager,
Centralized Case Processing-Lien Unit
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Part 1 -RECORDING OFFICE CAT. NO 600261