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Department of the Treasury - Internal Revenue Service
Form 668 M(c)
(Rev. February 2004)
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 886990012
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
additional penalties, interest, and costs that may accrue.
a Corporation
INC
ame of Taxpayer
Residence 110 LIMEKILN ROAD
NEW CUMBERLAND, PA 17070-2475
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,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
For Optional Use by Recording Office
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Kind of Tax
(a) Tax Period
Ending
(b)
Identifying Number
(c) Date of
Assessment
(d) Last Day for
Refiling
(e) Unpaid Balance
of Assessment
(f)
940 12/31/2011 23-3080500 04/30/2012 05/30/2022 2937.17
941 03/31/2009 23-3080500 04/30/2012 05/30/2022 50400.61
941 06/30/2009 23-3080500 05/07/2012 06/06/2022 36003.90
941 09/30/2009 23-3080500 05/07/2012 06/06/2022 26963.55
941 12/31/2009 23-3080500 04/30/2012 05/30/2022 56107.40
941 03/31/2010 23-3080500 07/09/2012 08/08/2022 46333.20
941 06/30/2010 23-3080500 07/09/2012 08/08/2022 54504.06
941 09/30/2010 23-3080500 07/09/2012 08/08/2022 42554.77
941 12/31/2010 23-3080500 07/09/2012 08/08/2022 44185.09
941 03/31/2011 23-3080500 07/09/2012 08/08/2022 30794.67
941 06/30/2011 23-3080500 04/30/2012 05/30/2022 23264.39
941 09/30/2011 23-3080500 05/07/2012 06/06/2022 31491.68
941 12/31/2011 23-3080500 04/02/2012 05/02/2022 25235.54
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 470776.03
This notice was prepared and signed at
the 09th day of August
DETROIT, MI
2012
, on this,
Signature Title
REVENUE OFFICER 22-06-1408
for MIGNA RODRIGUEZ (717) 777-9622
(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