HomeMy WebLinkAbout14-1747 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) 829 -3903 989820514
As provided by section 6321, 6322, and 6323 of the Internal Revenue y " A/ 7 1't:5 �G
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following -named taxpayer. We have made c
a demand for payment of this liability, but it remains unpaid. Therefore, CZ —
there is a lien in favor of the United States on all property and rights to rnUZ (:
property belonging to this taxpayer for the amount of these taxes, and � w r
additional penalties, interest, and costs that may accrue. c r' ru = i
Name of Taxpayer EMILY E SMITH
c) C
Residence
2002 COLUMBIA AVE �}
CAMP HILL, PA 17011 -5422
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 63251a ►.
Tax Period Date of Last Da yy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2011 XXX -XX -5620 05/28/2012 06/27/2022 657.70
1040 12/31/2012 XXX -XX -5620 06/03/2013 07/03/2023 1245.46
Place of Filing
Prothonotary
Cumberland County Total $ 1903.16
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 18th day of March 2014
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)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2 -2004)
CAT. NO 60025X