HomeMy WebLinkAbout13-5525 11883
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use b Recording Office
SMALL BUSINESS /SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829 -3903 961039813 f�L
As provided by section 6321, 6322, and 6323 of the Internal Revenue �3 - ss�s
Code, we are giving a notice that taxes (including interest and penalties) r
have been assessed against the following -named taxpayer. We have made
C--
a demand for payment of this liability, but it remains unpaid. Therefore, -03 Z Z
there is a lien in favor of the United States on all property and rights to r�� IM
property belonging to this taxpayer for the amount of these taxes, and -
additional penalties, interest, and costs that may accrue. f '"� .� o c;
Name of Taxpayer DAVID HAKE < r¢ ~r
CD
D C . CZ)
Residence 2289 MILL RD -�
MECHANICSBURG, PA 17055 - 6069 - o
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, a�. s o
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). OtIl a�����
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)
1040 12/31/2007 XXX -XX -7559 05/06/2013 06/05/2023 16353.43
1040 12/31/2008 XXX -XX -7559 05/06/2013 06/05/2023 9113.72
1040 12/31/2009 XXX -XX -7559 04/29/2013 05/29/2023 12660.58
1040 12/31/2010 XXX -XX -7559 04/15/2013 05/15/2023 9046.19
1040 12/31/2011 XXX -XX -7559 04/08/2013 05/08/2023 5049.05
Place of Filing
Prothonotary
Cumberland County Total $ 52222.97
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 13th day of September 2013
Signature Title
ACS SBSE 22 -00 -0001
for P.A. BELTON (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 -2004)
Part 1 - Kept By Recording Office CAT. NO 60025X