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HomeMy WebLinkAbout05-0367 1872 Department of the Treasury - Internal Revenue Service Form 668 (Y)(c) Notice of Federal Tax Lien (Rev. February 2004) 7L"os- 3(,.'7 F rL Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS/SELF EMPLOYED AREA #3 f"v P Jf/ Q I 'f,u'O Lien Unit Phone: (800) 829-3903 206563204 As provided by section 632t, 6322, and 6323 of the Internal Revenue Ck. /.2 0(,. Code, we are giving a notice that taxes (including interest and penalties) IL have been assessed against the following-named taxpayer. We have made /<9'/'1(. a demand for payment of this liability, but it remains unpaid. Therefore, r'-.' 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. - ;!:_~ ," .-.... Name of Taxpayer PETER J VERBOS III " C'~ - , Residence .- 6 FARM HOUSE LN - .-... - CAMP HILL, PA 17011-8349 .. , .-.- (j. 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 of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refihng of Assessment (a) (b) (c) (d) (e) (f) 1040 12/31/2001 205-56-2922 09/08/2003 10/08/2013 17456.83 Place of Filing Prothonotary Cumberland County Total $ 17456.83 Carlisle, PA 17013 This notice was prepared and signed at PHILADELPHIA, PA , on this, 23rd day of December 2004 the Signature Title ACS (800) 829-3903 23-00-0008 (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 Retordlng Office Form 668(Y)(c) {Rev. 2-20041 CAT. NO 60025X 11883 Department of the Treasury - Internal Revenue Service Form 668 (Z) (Rev. 10-24001 Certificate of Release of Federal Tax Lien Area: Serial Number For Use by Recording Office WAGE & INVESTMENT AREA #1 Lien Unit Phone: (800) 913-6050 206563204 I certify that the following-named taxpayer, under the requirements of section 6325 (a) of the Internal Revenue Code has satisfied the taxes listed below and all statutory additions, Therefore, the lien provided by Code section 6321 for these taxes and additions has been released. The proper officer in the office where the notice of internal revenue tax lien was filed on January 20 2005 , is authorized to note the books to show the release of this lien for - these taxes and additions. ; ntD =7,= ;=t Name of Taxpayer : T_ PETER J VERBOS III 10 -s -?i Residence 6 FARM HOUSE LN CAMP HILL, PA 17011-8349 COURT RECORDING INFORMATION: Liber Page UCC No. Serial No, wn{' -©? vt` n/a n/a n/a 05-367 FTL aT1;a&V Tax Period Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment R efiling of Assessment (a) (b) (c) (d) (e) (f) 1040 12/31/2001 XXX-XX-2922 09/08/2003 10/08/2013 17456.83 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total 1$ 17456.83 This notice was prepared and signed at DETROIT, MI the 05th day of November , 2010 Signature , on this, Title Director, Campus Compliance Operations 44 (NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000) Part 11 - RECORDING OFFICE CAT. NO 600261