HomeMy WebLinkAbout05-3863
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) /k. OS. 3.fG.3 FrL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 Ii. f.!;f( ~ IV, U\J
Lien Unit Phone: (800) 913-6050 238828905
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck- / S{,t}
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made KUA /t.tf(,1
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 J L SIPES AUTOMOTIVE INC , a Corporati n tJ ....,
.::-~ ~,
, C;'.' ,..,....,
C.1'I -n
..~. C. ~
Residence 6506 CARLISLE PIKE !j,
MECHANICSBURG, PA 17050-2354 ,.
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, - .
unless notice of the lien is reffled by the date given in column (e), this notice shall. --
on the day following such date, operate as a certificate of release as defined r<j
in IRC 6325(a). -; ".j .:2
",,"
Tax Period Date of Last Day for UnpaId Balance
Kind of Tax Ending Identifying Number Assessment Refihng of Assessment
(a) (b) (el (d) (e) (f)
941 06/30/2003 23-2941250 04/11/2005 05/11/2015 10266,50
941 12/31/2004 23-2941250 03/28/2005 04/27/2015 271. 28
941 03/31/2005 23-2941250 07/11/2005 08/10/2015 5487.17
Place of Filing
Prothonotary
Cumberland County Total $ 16024.95
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
20th day of July
2005
for JEFFREY WHITE
Title
REVENUE OFFICER
(717) 221-3490
23-09-1450
Signature
(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)
Part 1 - Kept By Recordlns omte
Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X