HomeMy WebLinkAbout13-0196Form 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 914646013
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 Taxpayer JEFFREY W ROSEWEIR
Residence 13 3 5 WINDSOR RD
MECHANICSBURG, PA 17050-6625
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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, a j S L, ~ • ~ , %
on the day following such date, operate as a certificate of release as defined ~°
in IRC 6325(a). ~ ~~.~
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Tax Period
Kind of Tax Ending Identifying Number
(a) (b) (c)
1040 ~ 12/31/2004 XXX-XX-8499
Place of Filing
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Date of Last Dayy for Unpaid Balance
Assessment Refifing of Assessment
02/06/2012 03/08/2022 ~ 1017.46
Prothonotary
Cumberland County
Carlisle, PA 17013
For Optional Use by Recording Office
Total ~ $ 1017 .4 6
This notice was prepared and signed at DETROIT, MI
the 04th day of January 2013
on this,
Signature Title
~\~~~-~ REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(NOTE: Certificate of officer authorized by law to take acknowletlgment Is not essential to the vauairy or rvot~ce or reaerai i ax nen
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 -Kept BY Recording Ofnce CAT. NO 60025X