HomeMy WebLinkAbout05-1380
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)( c) Notice of Federal Tax Lien
(Rev. February 20041
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 ()~ -12m ):T~
Lien Unit Phone: (412) 395-5265 216570705
As provided by section 6321, 6322, and 6323 of the Internal Revenue 11'-1- 00 /)cL
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made Ct<.:::::rL 12~2
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 Ro#-
property belonging to this taxpayer for the amount of these taxes, and !L.jq/l.!
additional penalties, interest, and costs that may accrue. (
Name of Taxpayer J L SIPES AUTOMOTIVE INC , a Corporati n
, ,"-)
<p.' "1)
_..~ ,-I
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Residence 6506 CARLISLE PIKE "
w' .~
MECHANICSBURG, PA 17050-2354 ..,w
- ,
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,
on the day following such date, operate as a certificate of release as defined p.)
in IRC 6325(al, ',: (..) ::'
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refillng of Assessment
(a) (b) (c) Cd) (e) (f)
941 06/30/2004 23-2941250 10/11/2004 11/10/2014 1027,49
941 09/30/2004 23-2941250 01/03/2005 02/02/2015 9442,20
Place of Filing
Prothonotary
Cumberland County Total $ 10469,69
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
02nd day of March
2005
Signature
Title
REVENUE OFFICER
(717) 221-3490
23-09-1450
for JEFFREY WHITE
(NOTE: Certificate of officer authorized by Jaw 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
Fmm 668(Y)(c) IRev. 2-2004)
CA T, NO 60025X