HomeMy WebLinkAbout14-3011 11883
Department of the Treasury - Internal Revenue Service
(Rev. February 20004)4)
Form 668 (YNotice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #1
Lien Unit Phone: (800) 913-6050 999651614 _
As provided by section 6321, 6322, and 6323 of the Internal Revenue �L
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 c7
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. -
=m
Name of Taxpayer LAURA BJURSTROM '
c;
Residence 25 BLUE MOUNTAIN VISTA
C'.
MECHANICSBURG, PA 17050 r '
G-)
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled b the date even in column (e), this notice shall,
on the day following such date, operate asga certificate of release as defined �G/
in IRC 6 225(a).
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 12/31/2012 XXX-XX-5100 06/03/2013 07/03/2023 43705 .48
Place of Filing
Prothonotary
Cumberland County Total $ 43705 .48
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 13th day of May 2014
Signature Title
�-� REVENUE OFFICER 21-03-2058
for D. JANSEN (212) 719-8114
(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) Form 668(Y)(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025X