HomeMy WebLinkAbout13-0011Form 668 (Y)(c)
(Rev. February 2004)
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 913217612
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 rights to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxnaver DAVID R MILLER
Residence 5 9 0 W LOUTHER ST
CARLISLE, PA 17013-2212
For Optional Use by Recording Office
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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, l '" `~-'
on the day following such date, operate as a certificate of release as defined ~~.,SC7 ~''f"` ~ G ~ y
in IRC 6325(a). ~~ :~~=y„~~y'.
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (~
1040 12/31/2001 XXX-XX-8550 05/08/2006 06/07/2016 27626.16
1040 12/31/2002 XXX-XX-8550 05/08/2006 06/07/2016 35162.46
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 62788.62
This notice was prepared and signed at
DETROIT, MI
the 20th day of December 2012
on this,
Signature ~''~,-.~ Title
~ \C-'~~ 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) Form 668(Y)(c) (Rev. 2-2004-
Part t - Kepc RY Recording Office CAT. NO 60025X