HomeMy WebLinkAbout12-4430Form 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 880348212
As provided by section 6321, 6322, and 6323 of the Internal Revenue
/ ?y311 _
L
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, c
,
there is a lien in favor of the United States on all property and rights to
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property belonging to this taxpayer for the amount of these taxe
and 2VW r ' :+
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JOHN R & NANCY M KEELER < =,
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Residence 402 KENT DR --
MECHANICSBURG, PA 17055-5529
IMPORTANT RELEASE INFORMATION: For each assessment listed b
]shall, unless notice of the lien is refiled by the date given in column (e), this notice
on the day f
ollowing such date, operate as a certificate of release as de
in IRC 6325(a). ?te ?;L7Yd?77
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2008 XXX-XX-5028 03/01/2010 03/31/2020 757.82
1040 12/31/2009 XXX-XX-5028 01/09/2012 02/08/2022 74660.67
1040 12/31/2010 XXX-XX-5028 11/14/2011 12/14/2021 22164.07
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 97582.56
This notice was prepared and signed at DETROIT, MI
the 10th day of July 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 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