HomeMy WebLinkAbout14-7354 14582
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 #214 - r15 q T'L
Lien Unit Phone: (800) 829-3903 135004214
As provided by section 6321, 6322, and 6323 of the Internal Revenue $<11'6v 01-r-
Code, we are giving a notice that taxes (including interest and penalties) (? ,,4 s44
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
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JORGE & LISA F DIAZ
M CZ an
r"I Im i
=:.; C-�
Residence 21 WHITE HOUSE RD ,
SHIPPENSBURG, PA 17257-9419 r�-=�-
<
IMPORTANT RELEASE INFORMATION: For each assessment listed below, - F--`
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 definedcn
o fRC 6325(a). •
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2011 XXX-XX-8550 07/28/2014 08/27/2024 22716 .6Q
Place of Filing
Prothonotary
Cumberland County Total $ 22716 . 60
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 16th day of December 2014
Signature �?� U � �' Title
ACS SBSE 22-00-0001
for P.A. BELTON (800) 829-3903
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rut. 71-466, 1971 - 2 C.B. 409) Fnrm 66t3[Y)(c) (Rev. 2-2004)