HomeMy WebLinkAbout12-0581Form 668 (Y)(c)
(Rev. February 2004)
3460
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) 913-6050 844243812
As provided by section 6321, 6322, and 6323 of the Internal Revenue f
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made t,
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 zM r-
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additional penalties, interest, and costs that may accrue. `
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Name of Taxpayer JAMES C WISE ;
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Residence 1401 SLATE HILL RD STE 300 C-
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CAMP HILL, PA 17011-8018 -
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
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following such date, operate as a certificate of release as defined
5
IRC
?70y
(a).
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 12/31/2009 XXX-XX-8622 02/15/2010 03/16/2020
1040 12/31/2009 XXX-XX-8622 12/19/2011 01/18/2022 1993.72
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 1993.72
This notice was prepared and signed at
the 23rd day of January
DETROIT, MI
2012
, on this,
Signature A,r1Ts?tc` REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(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 CAT. 668( (Rev. 2-2004)
CAT. NO 60025X