HomeMy WebLinkAbout04-5731Form 668 (Y)(c)
(Rev. February 2004)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
lien Unit Phone: (412) 395-5265 199662604
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 belonsJng to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
1872
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
'731 F'TI.--
For Optional Use by Recording Office
Name of Taxpayer WILLIAM J BUJAK
Residence 6493 CARLISLE PIKE
MECHANICSBURG, PA 17050-2377
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
in IRC 6325(a).
Tax Period Date ~
~nd ~ Tax Ending Identifying Number Assessment
(a) (b) (c) (d)
1040 12/31/1998 065-48-7632 05/31/1999
1040 12/31/1998 065-48-7632 06/05/2000
1040 12/31/1999 065-48-7632 06/05/2000
1040 12/31/2000 065-48-7632 04/15/2001
6672 03/31/2000 065-48-7632 06/22/2004
6672 06/30/2000 065-48-7632 06/22/2004
6672 09/30/2000 065-48-7632 06/22/2004
6672 12/31/2000 065-48-7632 06/22/2004
6672 03/31/2001 065-48-7632 06/22/2004
6672 06/30/2001 065-48-7632 06/22/2004
6672 09/30/2001 065-48-7632 06/22/2004
6672 12/31/2001 065-48-7632 06/22/2004
6672 03/31/2002 065-48-7632 06/22/2004
6672 06/30/2002 065-48-7632 06/22/2004
Last Day for
Retiring
(e)
o6/3o/2oo9
07/05/2010
07/05/2010
05/15/2011
07/22/2014
07/22/2014
07/22/2014
07/22/2014
07/22/2014
07/22/2014
07/22/2014
07/22/2014
07/22/2014
07/22/2014
876
909
1432
1058
607
486
689
434
47O
274
153
154
114
23
11
67
76
85
28
73
79
70
59
17
63
43
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 7662.94
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 08th dayof November , 2004
Signature ~ Title
REVENUE OFFICER 23-09-1459
for CINDY SIMCOX (717) 221-3490
(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 &&8(¥)(c) (Rev. 2-2004)
Part I - Kept By Recording Office CAT. NO 60025X