HomeMy WebLinkAbout12-5209Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 887576612
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 palyment 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.
ame of Taxpayer SI
PLUS I
Residence 469 E NORTH STREET
CARLISLE, PA 17013-2675
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). a7?G 3?
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) M
6721 12/31/2006 20-2285760 10/12/2009 11/11/2019 6096.60
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
For Optional Use by Recording Office
/a - S"24fa l /= 7'Z--
ks ?? ra
'J)r ?- no
Total 1 $ 6096.60
This notice was prepared and signed at
the 13th day of August
DETROIT, MI
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