HomeMy WebLinkAbout12-6115Form- 668 (Y)(c)
IRev.February 20041
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) 829-3903 895342412
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including merest and penakies)
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.
Name of Taxpayer ANDREW
Residence 2200 MARKET ST APT B
CAMP HILL, PA 17011-4643
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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,
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Tax Period Date of Last pay for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refl~ing of Assasstnent
(a) (b (c) (d e)
1040 12/31/2007 XXX-XX-0585 09/19/2011 10/19/2021 10221.71
1040 12/31/2008 XXX-XX-0585 09/19/2011 10/19/2021 19861.44
1040 12/31/2009 XXX-XX-0585 03/19/2012 04/18/2022 32953.54
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
For
Use by Recording Office
Total ~$ 63036.69
This notice was prepared and signed at
DETROIT, MI
on this,
the 21st day of September 2012
Signature Title
~ ~-~ ACS SBSE 22-00-0001
for P.A. BECTON (800) 829-3903
(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 OBIu Form 668(lf)(c) (Rev. 2-2004)
CAT. NO 60025X