HomeMy WebLinkAbout12-4513Form 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 ffice
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 880947612
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 rnm ?- -'
property belonging to this taxpayer for the amount of these taxes, and rte--
additional penalties, interest, and costs that may accrue. -<> o
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Name of Taxpayer MICHAEL A BARRETT -v
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Residence 706 MOORES MT RD -?-
MECHSNICSBURG, PA 17055
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,
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on the day following such date, operate as a certificate of release as defined
ion I 6325(a) a ? --/
-2
. 1
Tax Period Date of Last Day for Unpaid Bala ice
Kind of Tax Ending Identifying Number Assessment Refiling of Assessm nt
(a) (b) (c) (d) (e) (f)
CIVP 12/31/2008 XXX-XX-6669 03/07/2011 04/06/2021 29
l 7.34
Place of Filing
Prothonotary
Cumberland County Total $ 293 .34
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 12th day of July 2012
Signature AC
S SBSE 22-00 10001
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 li.n
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 22004)
Part 1 -Kept BY Recording Office CAT. NO 60 25x