HomeMy WebLinkAbout12-6536Form 668 MW
(Rev. February 2004)
4804
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 899261112
2
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As provided by section 6321, 6322, and 6323 of the Internal Revenue /_ 0
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. orrw.'
Name of Taxpayer MAT MEN INC, a Corporation j
RUSSO PAUL J tV
Residence 6425 CARLISLE PIKE X n
a,
MECHANICSBURG, PA 17050-2385
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LEASE INFORMATION: For each assessment listed below, `
e lien is refiled by the date given in column (e), this notice shall,
=
ng such date, operate as a certificate of release as defined
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
940 12/31/2011 61-1439421 05/07/2012 06/06/2022 415.57
941 12/31/2011 61-1439421 04/09/2012 05/09/2022 7305.64
941 03/31/2012 61-1439421 07/02/2012 08/01/2022 8972.71
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 16693.92
This notice was prepared and signed at
the 12th day of October
DETROIT, MI
2012
, on this,
Signature Title
?\C.a? REVENUE OFFICER 22-06-1441
for DENNIS P ZMUDZIN (717) 777-9624
(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