HomeMy WebLinkAbout05-0361
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) ft.,o:;. 31../ Frl
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 Ik f?1J '/'I.U,J
Lien Unit Phone: (800) 829-3903 207416405
A5 provided by section 632t, 6322, and 6323 of the Internal Revenue Ck p.o!'"
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made Sv. /ym!j
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 "
coon
additional penalties, interest, and costs that may accrue. c___ -~l
-r
.- 1-.0-:
..,.--
Name of Taxpayer THOMAS MILLER ",) "
c"
.
.--
.
Residence 209 1/2 RENO ST -
~.-.-
NEW CUMBERLND, PA 17070-2048 ..
. .
- c") --
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 6325Ia).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refihng of Assessment
(a) (b) (c) Cd) (e) (f)
1040 12/31/2000 102-44-3844 09/01/2003 10/01/2013 11832.21
Place of Filing
Prothonotary
Cumberland County Totai $ 11832.21
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
04th day of January
2005
Signature
Title
ACS
(800) 829-3903
23-00-0008
for L LEDER
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ru!. 71.466,1971.2 C.B. 4091
Part 1 - Kept By Recording Office
Form 668(Y)(c) IRev. 2.20041
CAT. NO 60025X