HomeMy WebLinkAbout05-1141
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 OS -}/41 'FIL....
Lien Unit Phone: (412) 395-5265 212945405
As provided by section 6321, 6322, and 6323 of the Internal Revenue ;j'14,60 j)cl
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made /)4"9
a demand for payment of this liability, but it remains unpaid. Therefore, C./L~
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 1:2.. :il- I ~ /?,PS
additional penalties, interest, and costs that may accrue.
Name of Taxpayer LORI FURRY
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Residence 871 W KING ST :'~"'. :J:J:)
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SHIPPENSBURG, PA 17257-9201 I rn
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, j"j
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unless notice of the lien is refiled by the date given in column (e), this notice shall, ~j (~
on the day following such date, operate as a certificate of release as defined c3 rn
in IRe 6325(a), N :6
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)
941 03/31/2003 23-2931918 07/21/2003 08/20/2013 1767,75
941 06/30/2003 23-2931918 09/08/2003 10/08/2013 2170,69
941 09/30/2003 23-2931918 01/12/2004 02/11/2014 638,52
941 12/31/2003 23-2931918 05/31/2004 06/30/2014 2291,85
941 03/31/2004 23-2931918 08/09/2004 09/08/2014 3610.46
941 06/30/2004 23-2931918 11/01/2004 12/01/2014 2311,27
Place of Filing
Prothonotary
Cumberland County Total $ 12790,54
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
07th day of February
2005
Signature
23-09-1459
Tirle
REVENUE OFFICER
(717) 221-3490
for CINDY SIMCOX
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rui. 71-466,1971 - 2 C.B. 409)
Part 1 - Kept By Recording Office
Form 668(Y)(c) IRev. 2.20041
CA T. NO 60025X