HomeMy WebLinkAbout13-1033Form 668 (Y)(c)
IRev. February 2004)
11883
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) 829-3903 922679113 ~~
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As provided by section 632 t, 6322, and 6323 of the Interna -
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made ,- ,...,,
Therefore
but it remains unpaid
ment of this liability
a demand for
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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 belon n to this taxpayer for the amount of these taxes, and
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additional penalties, interest, and costs that may accrue. ~-'~'
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Name of Taxpayer WILLIAM B GOLDSMITH ~'^~'.
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Residence 452 ALLENVIEW DR
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MECHANICSBURG, PA 17055-6167 ~-
IMPORTANT RELEASE INFORMATION: For each assessment listed below, ,...--
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unless notice of the lien is refiled by the date given in column (e), this notice shall, ' '
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on the day following such date, operate as a certificate of release as defined
in IRC 63251a). /~~- ;~.~- (J /l-'~~
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2011 XXX-XX-5692 05/28/2012 06/27/2022 10064.74
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 10064.74
This notice was prepared and signed at
the 14th day of February
DETROIT, MI
2013
on this,
Signature /~-~~{ 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. 2-20041
Part t -Kept By Recording Office CAT. NO 60025X