HomeMy WebLinkAbout12-7161Form 666 (Y)(c)
IRev. February 2004)
3460
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 ~p~f,SD Po ET
906874612
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322, 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 -
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a demand for payment of this liability, but it remains unpaid. Therefore, ~
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there is a lien in favor of the United States on all property and rights to ~
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property belonging to this taxpayer for the amount of these taxes
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additional penalties, interest, and costs that may accrue. ~~ % rv ~ ~;
Name of Taxpayer CLIFTON W GRIFFITHS ~`
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Residence
9 BARE RD ;;~ ~-- ::-
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MECHANICSBURG, PA 17050-3101 ~~ u
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).
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Dayy for
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (~
941 06/30/2002 25-1863795 09/06/2004 10/06/2014 5031.72
941 09/30/2002 25-1863795 06/23/2003 07/23/2013 8161.21
941 12/31/2002 25-1863795 07/14/2003 08/13/2013 8866.54
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 22059.47
This notice was prepared and signed at
DETROIT, MI
the 16th day of November 2012
on this,
Signature ~ Title
for
~ ~-~ ACS SBSE 22-00-0001
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 Office Form 668(Y)(c) IRev. 2-20041
CAT. NO 60025X