HomeMy WebLinkAbout05-1158
1872
Department of the Treasury - Internal Revenue Service
form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 20Q4)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 O~ ~/'~ ~
Lien Unit Phone: (412) 395-5265 214270205
As provided by section 6321, 6322, and 6323 of the Internal Revenue i /4, 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
a demand for payment of this liability, but it remains unpaid. Therefore, C21c.=# 1,2 Ycf
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:Z :#-- j/,/~P(~
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JEFFREY D & JOANNA POLLAK C' ;.:.:~ 0
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Residence 5020 E TRINDLE RD l ~(1ITl
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MECHANICSBURG, PA 17050-3621 ;~1
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, <.::) ;')iTi
unless notice of the lien is refiled by the date given in column (e), this notice shall, :~
.I:;- T'';
on the day following such date, operate as a certificate of release as defined :..0
- .<
in IRe 6325(al.
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)
1040 12/31/1993 087-36-4142 11/21/1994 N/A 6891,90
1040 12/31/1997 087-36-4142 11/23/1998 12/23/2008 6116.61
1040 12/31/1998 087-36-4142 03/12/2001 04/11/2011 10478,49
1040 12/31/1999 087-36-4142 03/12/2001 04/11/2011 11610.38
1040 12/31/2000 087-36-4142 11/25/2002 12/25/2012 13983.60
1040 12/31/2001 087-36-4142 11/25/2002 12/25/2012 8849,30
Place of Filing
Prothonotary
Cumberland County Total $ 57930.28
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
15th day of February
2005
the
Signature
Title
REVENUE OFFICER
(717) 221-3490
23-09-1450
for JEFFREY WHITE
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ru!. 71-466, 1971 - 2 C.B. 409)
Part , . Kept By Recording Office
Form 668(Y)(c) IRev. 2-20041
CA T. NO 60025X