HomeMy WebLinkAbout12-6951Form 668 (Y)(c)
(Rev, February 2004)
11883
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 904575012
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 payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and righu to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
ame of r axpayer
MD F A C R
Residence 10 O l S MARKET ST STE D
MECHANICSBURG, PA 17055-4748
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).
For Optional Use by Recording Office
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Tax Period Date of Last Dayy for lJnpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
941 06/30/2012 30-0026368 10/08/2012 11/07/2022 6726.23
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 6726.23
This notice was prepared and signed at
the 06th day of November
DETROIT, MI
2012
on this,
Signature / ~- Title
~ 1~~. 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)
Part 1 -Kept By Recording Office Form 668(Y)(c) IRev. 2-20041
CAT. NO 60025X