HomeMy WebLinkAbout12-6411Form 668 (Y)(c)
(Rev. February 2004)
1
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 898119212
As provided by section 6321, 6322, and 6323 of the Internal Revenue l/ y?? /C7G
Code, we are giving a notice that taxes (including Interest and penalties)
have been assessed apinst the following-named taxpayer. We have nude
a demand for payment of this liability, but it remains unpaid. Therefore,
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there is a Hen in favor of the United States on all property and rights to
property belongs to this taxpayer for the amount of these taxes, and r''M Cl)
additional penakies, Interest, and costs that may accrue. ,
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Name of Taxpayer DAVID E MILLER - f
Residence 1950 WAGGONERS GAP RD "
CARLISLE, PA 17013-8359
IMPORTANT kELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (a), this notice shall,
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on the day following such date, operate as a certificate of release as defined r0
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in (RC 6325(a). ?p,.?¢ aZ ?/?'1I?
'tax Period Date of Last Dater for Unpaid BaHnce
Kind of Tax Ending Identifying Number Assess me t g of Assessment
a) b c) d e
1040 12/31/1997 XXX-XX-2133 09/27/2004 10/27/2014 11067.25
1040 12/31/2001 XXX-XX-2133 10/29/2007 11/28/2017 5735.00
1040 12/31/2002 XXX-XX-2133 07/11/2005 08/10/2015 4242.13
1040 12/31/2003 XXX-XX-2133 10/29/2007 11/28/2017 5184.32
1040 12/31/2004 XXX-XX-2133 10/29/2007 11/28/2017 8364.41
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 34593.11
This notice was prepared and signed at DETROIT, MI
the 05th day of October 2012
, on this,
Signature c? ACS W&I 11-00-0000
for DEBRA K. HURST (800) 829-7650
(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 Rwwding Office CAT. 668( (Rev. 2-20041
CAT. NO 60025X