HomeMy WebLinkAbout12-2752Form 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) 913-6050 863625112
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As provided by section 6321, 6322, land 6323 of the Internal Revenue
Code, we are giving a notice that tax s (including interest and penalties)
have been assessed against the follow' g-named taxpayer. We have made
a demand for payment of this 'iabllity but it remains unpaid. Therefore,
there is alien in favor of the United tates on all property and rights to N
property belonging to this taxpayer f r the amount of these taxes, and rrico
additional penalties, interest, and cos that may accrue. X M
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Name of Taxpayer LORI J CAREY ?-
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Residence
PO BOX 711 '-'
`7-
NEW CUMBERLND,' PA 17070-0711 4
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IMPORTANT RELEASE INFORMATI N: For each assessment listed below
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unless notice of the lien is refiled by the d to given in column (e), this notice shall .
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on the day following such date, operate as a certificate of release as defined
IRC 6325(
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identify! g Number Assessment Refilli ng of Assessment
(a) (b) c) (d) (e) (f)
1040 12/31/2009 XXX- X-7343 02/07/2011 03/09/2021 1236.02
Place of Filing
Prothonotary;
Cumberland Cbunty Total $ 1236.02
Carlisle, PA117013
This notice was prepared and signed at
the 25th day of April
DETROIT, MI
2012
, on this,
Signature Title
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 t-ederal i ax uen
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X