HomeMy WebLinkAbout04-4977Form 668 (Y)(c)
(Rev. February 2004)
Area: J Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 191059104
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 foJlm~Jng-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 tn
property belonging tn this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accn~e.
Name of Taxpayer GREAT LOCATIONS INC , a Corporation
1872
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optio~laJ Use by Recording Office
Residence
3731 MARKET ST
CAMP HILL, PA 17011-4326
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is raffled by the date given in column lei, this notice shall,
on the day following such date, operate as e certificate of release as defined
in iRC 63251a).
Tax Period Date of Last Day for
Kind of Tax Ending Identifying Number Assessment Reflling
(a) (h) (c) (d) (e)
940 12/31/2003 25-1708109 06/21/2004 07/21/2014
941 12/31/2003 25-1708109 06/21/2004 07/21/2014
Unpaid Balance
of Assessment
1266.87
24782.51
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
26049.38
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 09th day of September, 2004
for DARLENE FISHER
Title
REVENIIE OFFICER
(717) 221-3490
23-11-1439
(~IOT~: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ruf. 71-466, 1971 - 2 C.~. 409)
Part ! - Kept ~ Recording Office Form 668(Y)(c) (Rev. 2-20041
CAT. NO 6OO25X