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HomeMy WebLinkAbout05-0692 1872 form 668 (Y)(C) (Rev. February 2004) Department of the Treasury - Internal Revenue Service Notice of Federal Tax Lien 710 () 5- l, 12. r:T L Area: Serial Number SMALL BUSINESS/SELF EMPLOYED AREA #3 Lien Unit Phone: (800) 829-3903 210103605 As provided by section 632t, 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 belonging to this taxpayer for the amount of these taxes, and addItional penalties, interest, and costs that may accrue. Name of Taxpayer SOUTHS IDE ASSOCIATES INC % ROGER HOSFELT For Optional Use by Recording Office /d. PYi' Ii N ()'J OLIVO:) IG. /(,/)</33> (:--J ~J j --q r-q (.i., , C) Residence 112 BIG POND RD SHIPPENSBURG, PA 17257-9022 (~-) .r- IMPORTANT RELEASE INFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column Ie), this notice shall, on the day following such date, operate as a certificate of release as defined in IRC 6325(a). Kind of Tax a CIVP Tax Period Ending (b) 12/31/2000 Identifying Number (c) 25-1820739 Date of Assessment (d) 09/29/2003 Last Day for Refihng e) 10/29/2013 Unpaid Balance of Assessment (f) 12216.28 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 Total $ 12216,28 This notice was prepared and signed at PHILADELPHIA, PA ,on th the 20th day of January 2005 Signature Title ACS (800) 829-3903 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lief - . "'1-466, 1971 ~ 2 C.B. 409} 23-00-0 Part . .. Kept By Recording Office Form 668(Y)(c) IRev. 2-: CAT. NO 600