HomeMy WebLinkAbout13-5202 11883
Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
(Rev. February 2004) 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 957614013
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 c C
a demand for payment of this liability, but it remains unpaid. Therefore, r - 0
there is a lien in favor of the United States on all property and rights to z M r 1
property belonging to this taxpayer for the amount of these taxes, and }°
additional penalties, interest, and costs that may accrue.
Name of of Taxpayer HOLLIE M ADAMS D� z
TREEHOUSE KIDS CLUB _X '
Residence
278 COLONIAL
SHIPPENSBURG, PA 17257 -0000
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, off/ S� �• 77
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). �2
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
940 12/31/2008 20- 5019298 11/28/2011 12/28/2021 642.57
940 12/31/2009 20- 5019298 11/28/2011 12/28/2021 676.82
941 03/31/2007 20- 5019298 04/28/2008 05/28/2018 2634.87
941 06/30/2007 20- 5019298 04/28/2008 05/28/2018 3078.89
941 09/30/2007 20- 5019298 04/28/2008 05/28/2018 3951.11
941 12/31/2007 20- 5019298 04/21/2008 05/21/2018 4397.47
941 12/31/2008 2075019298 11/28/2011 12/28/2021 14262.42
941 03/31/2009 20- 5019298 11/28/2011 12/28/2021 .14458.96
Place of Filing
Prothonotary
Cumberland County Total $ 44103.11
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 27th day of August 2013
Signature Title
\� REVENUE OFFICER 22 -06 -1418
for JAKOB PEDERSEN (717) 777 -9621
(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)
Part 1 - Kept By Recording Office Form 668( CAT (Rev. 2 - 2004►
CAT. NO 60025X