HomeMy WebLinkAbout12-3860Form 668 (Y)(c)
(Rev. February 2004)
11883
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 873790312
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 4
additional penalties, interest, and costs that may accrue. ' t `
1771
Name of Taxpayer EVA DEBRAGANZA
Residence 407 SCOTT DR
SHIPPENSBURG, PA 17257-2168
-.a
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
F -
following such date, operate as a certificate of release as defined
IRC
5(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2008 XXX-XX-0025 11/21/2011 12/21/2021 43411.43
1040 12/31/2009 XXX-XX-0025 02/20/2012 03/22/2022 83780.90
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 127192.33
This notice was prepared and signed at DETROIT, MI
the 11th day of June 2012
, on this,
Signature Title
` \C--? REVENUE OFFICER 22-06-1441
for DENNIS P ZMUDZIN (717) 777-9624
(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 60025X