HomeMy WebLinkAbout13-1036Form 668 (Y)(c)
(Rev. February 2004)
118
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 922711513
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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 i-=~ 7, ~ ~ -
additional penalties, interest, and costs that may accrue. ~~ : `'~
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Name of Taxpayer ROBERT HOCK
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Residence 22 SCRAFFORD ST ~
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SHIPPENSBURG, PA 17257-1728 ,,,
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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, ,r
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on the day following such date, operate as a certificate of release as defined . ~
in IRC 6325(a). ~~ ~ G ~~~
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 12/31/2001 XXX-XX-7991 07/24/2006 08/23/2016 5486.20
1040 12/31/2002 XXX-XX-7991 02/06/2006 03/07/2016 1164.23
1040 12/31/2003 XXX-XX-7991 12/05/2005 01/04/2016 1282.93
Place of 1=ifing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 7933.36
This notice was prepared and signed at
the 14th day of February
DETROIT, MI
2013
on this,
Signature /~ Title
\ `C-'~-~ REVENUE OFFICER 22-06-2620
for JACOB KAISER (304) 263-7625
(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 1 -Kept By Recording Office CAT. NO 60025X