HomeMy WebLinkAbout05-3564Form 668 (Y)(c)
)Rev. February 2004)
18
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien -)IA .(?,_C_ z</_ v L~ T-L
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 /r
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Lien Unit Phone: (8o0) 829-3903 236129305 4
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As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck 0.2 9 q
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made 16 6 3 dU
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 ROXANNE BALOG n
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Residence 113 S 31ST ST c_ L
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CAMP HILL, PA 17011-4510 r
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, r,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
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on the day following such date, operate as a certificate of release as defined U
in IRC 6325(a). N `z7
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
a) (b) (c (d) a (f)
1040 12/31/1999 168-52-4854 08/21/2000 09/20/2010 1129.35
1040 12/31/2000 168-52-4854 05/24/2004 06/23/2014 3577.46
1040 12/31/2001 168-52-4854 05/10/2004 06/09/2014 1831.32
1040 12/31/2002 168-52-4854 05/10/2004 06/09/2014 2068.72
1040 12/31/2003 168-52-4854 05/31/2004 06/30/2014 1127.08
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
the 05th day of July
PHILADELPHIA, PA
2005
Total 1$
9733.93
on this,
Signature I Title
ACS 23-00-0008
for L LEDER (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. Rul. 71-466,1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60026X
3 756 Department of the Treasury - Internal Revenue Service
Form 668 (Z)
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use b Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 913-6050
236129305
pct YP,LM
I certify that the following-named taxpayer, under the requirements of section 6325 (a) Ch- 3 3 .S??
of the Internal Revenue Code has satisfied the taxes listed below and all statutory F J&
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additions. Therefore, the lien provided by Code section 6321 for these taxes and a"'.
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on July 14
2005 , is authorized to note the books to show the release of this lien for
these taxes and additions. 0 0
d
Name of Taxpayer
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3t
OXANNE BALOG : r r
Residence 113 S 31ST ST
CAMP HILL, PA 17011-4510
••
COURT RECORDING INFORMATION: ? o
Liber Page UCC No. Serial No.
n/a n/a n/a 053564 s?
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment last Day for
RefMnp Unpaid Babnce
of Assessment
a b a d • f
1040 12/31/1999 XXX-XX-4854 08/21/2000 09/20/2010 1129.35
1040 12/31/2000 XXX-XX-4854 05/24/2004 06/23/2014 3577.46
1040 12/31/2001 XXX-XX-4854 05/10/2004 06/09/2014 1831.32
1040 12/31/2002 XXX-XX-4854 05/10/2004 06/09/2014 2068.72
1040 12/31/2003 XXX-XX-4854 05/31/2004 06/30/2014 1127.08
******** ********** ************* ********** ************ ****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 9733.93
This notice was prepared and signed at
the 23rd day of February
Signature
DETROIT, MI
2009
, on this,
Title Director, Campus Compliance
Operations
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Part 1 - RECORDING OFFICE CAT. NO 600261