HomeMy WebLinkAbout12-0732Form 668 (Y)(c)
(Rev. February 2004)
3
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 846121012 1
;Z 73 D
_ _
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 ,
property belonging to this taxpayer for the amount of these taxes, and CC ? -=
additional penalties, interest, and costs that may accrue. M
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Name of Taxpayer SCOTT FONNER
Residence 1503 EMBASSY DR `--
HARRISBURG, PA 17109-5611
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall, /0"l, 6?, ?•
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). F--T--- ?n
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Day for
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2009 XXX-XX-1364 01/09/2012 02/08/2022 8985.59
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 8985.59
This notice was prepared and signed at DETROIT, MI on this,
the 30th day of January 2012
Signature Title
REVENUE OFFICER 22-06-1407
for SEAN DUNLEAVY (717) 777-9626
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-46f, 1971 - 2 C.B. 409)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X