HomeMy WebLinkAbout12-4693Fore 6" (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Nye of FedWal Tax Lien
Area: Serial Number For Options( Use by Recordir
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 882219412
As pr a by sa reins 6321, 6322, and 6323 of the ImMuM Rwalue 93 CTi
Code, we are dint a Itile?E o doe tares (kKkl bt hlt+ef+est and per wNes)
here been assomd` sooko the fal ranod taxpaw. We have made
a demaad for pwjsww of dds lllll ky, but It renWo =*old. ThwI mv,
there h a $a b lhvw of dw tht1ted States on al property and r to )
property bI 11, el s to_Wx ter for die amoom of these taxes, and N
ad and pewidl*4 howes4 and costs that may accnte.
Name of Taxpayer G ST (M-y?
i
Residence 77 BIDDLE RD
CARLISLE, PA 17015-9794 7TH
r
c
114P TA$IT ? III ATtOM: For each assessment listed below,
unless notice of the lien Is refiled by the date given in column (e), this notice shall, ? 0(( ? on the day following such date, operate as a certificate of release as defined
in IRC 8325{a).7Y 7 3 3
PW%d ow 1W
Kind of Tax Tax tuft klentMK Number 0fltte d Last 111ti
Office
c=
rn, .
--4Q
a-n
o' c-.
r?
3w
7D
6672 106/30/20091 XXX-XX-7767 106/25/20121 07/25/2022 I 17147.35
Place of Filing
Prothonotary
Cumberland County Total $ 1714 .35
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
the 18th day of July 2012
Signature ? C-40? RtiEVENUE OFFICER
for JAKOB PEDERSEN (717) 777-9621
(NOTE 7w cats of officer authorized by law to take acknow"ment Is not essential to the validity of Not
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form
Fare 1 - KW BRsoorftONke
, On this,
22-061-1418
Federal Tax
If)(c) (Rev.
CAT. NO 6