HomeMy WebLinkAbout12-0403Form 668 (Y)(c)
(Rev. 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 839995412
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As provided by section 6321, 6322, and 6323 of the Internal Revenue 7z- -----
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Code, we are giving a notice that taxes (including interest and penalties) ,
have been assessed against the following-named taxpayer. We have made -a +? -
a demand for payment of this liability, but it remains unpaid. Therefore, MM pcw :?1r
there is a lien in favor of the United States on all property and rights to =::o :=
property belonging to this taxpayer for the amount of these taxes, and (np r,.) ;Q
additional penalties, interest, and costs that may accrue. '
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Name of Taxpayer DUSTIN L PALMER =
Residence 202 OLD YORK RD APT B
NEW CUMBERLND, PA 17070-3402
ANT RELEASE INFORMATION: For each assessment listed below,
ce of the lien is refiled by the date given in column (e), this notice shall,
E
y following such date, operate as a certificate of release as defined
IR
25(a). 7?a? 7
Tax Period Date of La st Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-4235 12/13/2010 01/12/2021 11118.27
1040 12/31/2008 XXX-XX-4235 03/07/2011 04/06/2021 2138.18
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 13256.45
This notice was prepared and signed at DETROIT, MI
the 05th day of January 2012
, on this,
Signature Title
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) Form 668(Y)(c) (Rev. 2-2004)
Part i -Kept By Recording Office CAT. NO 60025X
Form 668 (Z)
(Rev. 10-2000)
11883 Department of the Treasury - Internal Revenue Service
Certificate of Release of Federal Tax Lien
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050
Serial Number
839995412
For Use by Recording Office
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 January 27
2012 , is, authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer
DUSTIN L PALMER
Residence202 OLD YORK RD APT B
NEW CUMBERLND , PA 17070-3402
Liber
n/a
COURT RECORDING INFORMATION:
Page UCC No. Serial No.
n/a n/a 12-403
9. A 17-
gt ?29
2
Kind of Tax
(a)
Tax Period
Ending
(6)
Identifying Number
(c)
Date of
Assessment
(d)
st Day for
Kerning
(e)
Unpaid Balance
of Assessment
(f)
1040
1040
*******
12 / 31/ 2 0 0 5
12 / 31/ 2 008
****
XXX -XX -4235
XXX -XX -4235
***********
12/13/2010
03/07/2011
***********
01/12/2021
04/06/2021
11118.27
2138.18
*******
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 13256.45
This notice was prepared and signed at
the
14th day of May
DETROIT, MI , on this,
2014
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