HomeMy WebLinkAbout12-2469Form 668 (Y)(c)
(Rev. February 2004)
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 861248012
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As provided by section 6321, 6322, and 6323 of the Internal Revenue 7[0
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
additional penalties, interest, and costs that may accrue.
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Name of Taxpayer DAVID R ECKERT :?o
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Residence
PO BOX 1342 MW
MECHANICSBURG, PA 17055-1342 C4 =
NT RELEASE INFORMATION: For each assessment listed below, c-n
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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 o
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IRC
5(a).
Tax Period Date o f Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2002 XXX-XX-8257 11/21/2005 12/21/2015 15728.42
1040 12/31/2003 XXX-XX-8257 08/06/2007 09/05/2017 26393.14
1040 12/31/2004 XXX-XX-8257 08/06/2007 09/05/2017 7289.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 49411.31
This notice was prepared and signed at
the 13th day of April
DETROIT, MI
2012
, on this,
Signature Title
ACS SBSE 22-00-0001
for P.A. BELTON (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 1 - Kept By Recording Office CAT. NO 60026X