HomeMy WebLinkAbout13-1141Form 668 (Y)(c)
IRev. February 20041
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 923824513
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.
ame of I axpayer
Residence 2815 FAIRVIEW RD
CAMP HILL, PA 17011-1623
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, ~'
on the day following such date, operate as a certificate of release as defined ,~~ •_SZ~ f'Gi? ' ~~ ' ~ '
in IRC 6325(a). ,~,.if'tl a /~J•7
Tax Period
Kind of Tax Ending
6672 09/30/2011
6672 12/31/2011
6672 03/31/2012
Place of Filing
Identifying Number
(c) --
XXX-XX-4028
XXX-XX-4028
XXX-XX-4028
Prothonotary
Cumberland County
Carlisle, PA 17013
Date of
Assessment
12/31/2012
12/31/2012
12/31/2012
46621.43
33897.77
18441.69
Total ~$ 98960.89
This notice was prepared and signed at
the 21st day of February
DETROIT, MI
2013
on this,
Signature ~ ~~~ REVENUE OFFICER 22 - 06 -1418
for JAKOB PEDERSEN (717) 777-9621
Last Dayy for
Refiling
01/30/2023
01/30/2023
01/30/2023
unpaid Balance
of Assessment
(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(ln(c) IRev. 2-2004)
Part 1 -Kept BY Recording Office CAT. NO 60025X