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HomeMy WebLinkAbout13-0012 11883 Department of the Treasury -Internal Revenue Service Form 668 (Y)(c) (Rev. February 2004) Notice of Federal Tax Lien Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS/SELF EMPLOYED AREA #2 Lien Unit Phone: (800) 829-3903 913597112 As provided by section 6321, 6322, and 6323 of the Internal Revenue ~-3 "" ~~ ~ /~ ~~ 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 Taxpayer JANE ADAMS ~1 ` _-~"' . t ,,, x. r*2 ~ ~ r-- t ~ ~„ Residence 317 WOODLAND AVE r~ N © ' NEW CUMBERLND , PA 17 0 7 0 -18 81 ~ ~ "'a ~ a ~ ~ ~ ~ ~ A~ t~ p~ 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 followin such date t ifi ~ ~ / s ~ ~ ~ , ~, ~. ,~, ~ ~ g , opera e as a cert cate of release as defined / -• in IRC 6325(a). n ~,~, ~ ~ y ~~~ ,' Kind of Tax Tax Period Ending Identifying Number Date of Assessment Last Dayy for Refiling lJnpaid Balance of Assessment (a) (b) (c) (d) (e) (~ 1040 12/31/2001 XXX-XX-9200 10/19/2009 11/18/2019 58754.92 1040 12/31/2003 XXX-XX-9200 10/10/2005 11/09/2015 5287.61 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total ~$ 64042.53 This notice was prepared and signed at DETROIT, MI the 21st day of December 2012 on this, Signature /'~'~ Title ~ \~~ ACS SBSE 22-00-0001 for P.A. BECTON (800).829-3903 (N~7'E: 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) (Rev. 2-20041 CAT. NO 60025X