HomeMy WebLinkAbout12-5704 118'$ 3
Department of the Treasury -Internal Revenue Service
Form 6se cYx~~ Notice of Federal Tau Lien
(Rev. February 2004)
Area: Serial Number For Optional Use',. by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913*6050 891792612 ,S7O~
As provided by section 6 ~1, 6322, and 6323 of the Internal R~evem~e
Code, we are I a that taxes (hl~dudh~ hl~terest and penakies)
have been as>~essed ~ foHo~win~-named taxpa~rer. We have made '"r'
a demand far p of liability, but it rem~s unpa#d. Therefore,
there is a lien in favor of tJnhed Statss on aM property and ruts to ~
property beio to Itaaxpayer for the amount of these taxes, and _ ~
addhlbnal penakks, ,and costs that may accrue. ~ ~ t
Name of Taxpayer MARY E DOPER = q~-ri
CRIMSO~rT FROG COFFEEHOUSE ~d
z ~
Residence 1104 LISLE ROAD
o''
CAMP H~L~L, PA 17011-6203
IMPORT~fi' RELEASE QRMATION: For each assessment listed below,
unless notice of the lien is re i ed by the date given in column (e!, this notice shall, o~,w yy~ • L%• ~
on the day following such ~3te, operate as a certificate of release as defined
in IRC 8325(a!. ~ ~~dQo~3
Tax Period I, Date of Last fa' Maid Balalltnce
Kind of Tax Ending Identifying Number Assessment RI of Asressmlent
a b c d e
6721 12/31/2001,9 20-1551268 04/30/2012 05/30/2022 330.00
Place of Filing
ProtY~onotary
Cumbek~'land County Total $ 330.00
Carlij~le, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 05th day of S~~tember 2012
,
Signature RtI~~E 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 6~!Q(n{~) IRev. 2-2004)
Part 1 'Kept ff{p Recoris OAke CAT. NO 60025X