HomeMy WebLinkAbout05-1157
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
WAGE & INVESTMENT AREA #2 )::~
Lien Unit Phone: (800) 829-7650 214263405 D!: -IIS1
As provided by section 632 t, 6322, and 6323 of the Internal Revenue {//"-/.DO ~cl
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made J,) Lf rf
a demand for payment of this liability, but it remains unpaid. Therefore, ccd
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 ,), ctL.{101 ~~;~
additional penalties, interest, and costs that may accrue. ,-
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Name of Taxpayer RANDALL BOOMER - :;:1
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Residence 307 N ENOLA DR ;\,.'
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ENOLA, PA 17025-2217 ..... "
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, L- j~
unless notice of the lien is refiled by the date given in column (e), this notice shall, C:l
on the day following such date, operate as a certificate of release as defined
in IRe 63251al.
Tax Period Date of Last DaK. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2001 197-40-5772 10/06/2003 11/05/2013 4944.91
1040 12/31/2002 197-40-5772 09/29/2003 10/29/2013 156.25
Place of Filing
Prothonotary
Cumberland County Total $ 5101.16
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
,on this,
the
15th day of February
2005
Signature
Title
ACS
(800) 829-7650
12-00-0000
for P SLANE
(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) IRev. 2-20041
CAT. NO 60025X
Area: Serial Number
WAGE & INVESTMENT AREA #2
Lien Unit Phone: (800) 913-6050 214263405
I certify that the following-named taxpayer has met one or more of the elements
of the Internal Revenue Code (IRC) section 63Z3(j). The Internal Revenue Servic
therefore withdraws the Notice of Federal Tax Lien for these taxes and additions.
The withdrawal of this notice of lien does not affect the statutory lien provided
by IRC section 6321; it simply relinquishes any lien priority obtained by the Inte
Revenue Service when the notice was filed. The proper official, in the office wher
the Notice of Federal Tax Lien was filed on March 04 2005
is authorized to update the records to show the wIthdrawal of the notIce of en
for these taxes and additions.
Name of Taxpayer RANDALL BOOMER
Form10916(c)
(Rev. 10-2000}
Residence
Liber
n/a
Kind of Tax
(a)
1040
1040
*******
Place of Filing
3469 Department of the Treasury - Internal Revenue Service
Withdrawal of Filed Notice of Federal Tax Lien
For Optional Use by Recording Office
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307 N ENOLA DR
ENOLA, PA 17025-2217
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COURT RECORDING INFORMATION:
Page UCC No. Serial No.
n/a n/a 05-1157 FTL
Tax Period
Ending
(bl
12/31/2001
12/31/2002
C..
c.
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_s...
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Identifying Number
(e)
197-40-5772
197-40-5772
Date of
Assessment
(d)
10/06/2003
09/29/2003
Last Day for
Refiling
(e)
11/05/2013
10/29/2013
************
Unpaid Balance
of Assessment
(I)
4944.91
156.25
*****************
********** ************* **********
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
5101.16
PHILADELPHIA, PA
, on this,
This notice was prepared and signed at
the 09th day of July
Signature
Cat, No. 24586T
2005
Title Director, Payment Compliance
Form10916(c) (Rev. 10-20001
Part 1 - Recording Office