HomeMy WebLinkAbout14-6687 11883
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev.February 2004) ]Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 1 129666414
As provided by section 6321, 6322, and 6323 of the Internal Revenue
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 XM C:)
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. -<> ¢ CD
r—
Name of Taxpayer KEITH B DEARMOND <
90
Residence49 S PITT ST co
CARLISLE, PA 17013-3210
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
0 T-
unless notice of the lien is refiled by the date given in column (e), this notice shall, ;21. '7
t�
0 C
P
le
� Is
on the day following such date, operate as a certificate of release as defined
I the 3 y
in IRC 6325(a).
3135",
Tax Period Date of Last Day/for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) W (d) (e) (f)
1040 12/31/2012 XXX-XX-6309 09/22/2014 10/22/2024 21928 .66
Place of Filing
Prothonotary
Cumberland County Total $ 21928 . 66
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 10th day of November , 2014.
Signature REVENUE OFFICER 22-06-2624
for JAKOB A PEDERSEN (717) 777-9621
(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