HomeMy WebLinkAbout05-3053
1872
Department of the Treasury' Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
{Rev. Februarv 2004\ n, () 0-' 30S3 F'rL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 ~. (/'_1/ E 1'1', c.!'!)
Lien Unit Phone: (800) 913-6050 231411105
As provided by section 6321, 6322, and 6323 of the Internal Revenue Uc.. ..-;"?tf
Code, we are giving a notice that taxes (including Interest and penalties)
have been assessed against the following-named taxpayer. We have made (L It- ~ ';lII-/
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 SCULPTURED IMAGES INC , a Corporation
Residence FRONT 0 ....,
204 S ST c;:, 0
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WORMLEYSBURG, PA 17043-1335 <"' "'"'
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, - '.nm
unless notice of the lien is refiled by the date given in column (e), this notice shall, , c- COy
on the day following such date, operate as a certificate of release as defined '. ~~1o
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in IRC 6325(a). ('C:~~
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Tax Period Date of Last Dad. for unt; B'iian~'
Kind of Tax Ending Identifying Number Assessment Refi 109 of eren :g
(al (b) (c) (d) (e) ( '"
941 09/30/2004 25-1742254 05/16/2005 06/15/2015 4346.67
Place of Filing
Prothonotary
Cumberland County Total $ 4346.67
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
06 th day of June
2005
Signature
Title
REVENUE OFFICER
(717) 221-3490
23-09-1459
for CINDY SIMCOX
(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. 4091
Part 1 . Kept By Recording Office
Form 668(Y)(c) (Rev. 2.20041
CAT. NO 60025X
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