HomeMy WebLinkAbout12-4630Form 668 (Y)(c)
(Rev. February 2004)
1188
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 881610112 3d
A
i
s prov
ded 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 c (`'?==
additional penalties, interest, and costs that may accrue.
Name of Taxpayer BRIAN E NOLL rr-X
<a -p = -
r,-
Residence 9 ENCK DR r rV ;n; fry
BOILING SPRGS, PA 17007-9729 _ r ?
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,
a/. S7J /0o1.
z -
on the day following such date, operate as a certificate of release as defined
o
i
n I 6325(a). a 7? 37?
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Day for
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/1991 XXX-XX-9200 05/25/1992 06/24/2022 683.00
1040 12/31/2003 XXX-XX-9200 08/22/2005 09/21/2015 6617.59
1040 12/31/2004 XXX-XX-9200 11/28/2005 12/28/2015 20479.97
1040 12/31/2005 XXX-XX-9200 06/04/2007 07/04/2017 5879.80
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 33660.36
This notice was prepared and signed at
the 16th day of July
DETROIT, MI
2012
, on this,
Signature Title
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)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X