HomeMy WebLinkAbout14-2893 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 998514814
As provided by section 6321, 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 madeC= -;
a demand for payment of this liability, but it remains unpaid. Therefore, ri Go '- _
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 U)r c '
additional penalties, interest, and costs that may accrue. r—
Name of Taxpayer JACOB M BRENNEMAN x'C"= 7r-:'
Residence 306 SHATTO DR
CARLISLE, PA 17013-2139
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, v t
on the day following such date, operate as a certificate of release as definedf /� /,��
in IRC 6325(a). F� 3 OS 7T
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 12/31/2010 XXX-XX-0604 06/10/2013 07/10/2023 3880 .24
1040 12/31/2011 XXX-XX-0604 06/17/2013 . 07/17/2023 3995 . 07
Place of Filing
Prothonotary
Cumberland County Total $ 7875 .31
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 06th day of May 2014
Signature /"�-�C � 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