HomeMy WebLinkAbout12-2468Form 668 (Y)(c)
(Rev. February 2004)
4804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 860904012
venue
As provided by section 6321, 6322, and 6323 of the Internal Re 70
n
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 3 r„ --+
additional penalties, interest, and costs that may accrue.
Name of Taxpayer TERRY E FREEMAN '
r" - tC
Residence 1219 HIGHLANDER WAY
xC = =-
:
MECHANICSBURG, PA 17050-8302 ,.
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,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). Or
a7yl ?
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2010 XXX-XX-7223 12/05/2011 01/04/2022 4852.72
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 4852.72
This notice was prepared and signed at DETROIT, MI
, on this,
the 12th day of April 2012.
Signature Title
REVENUE OFFICER 22-06-1408
for MIGNA RODRIGUEZ (717) 777-9622
(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 Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X