HomeMy WebLinkAbout05-4167
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (800) 829-3903 241902805 c:;..) ~ L( I (" 7 FI/.. .j
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 f~ 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 575'1
property belonging to this taxpayer for the amount of these taxes, and C
additional penalties, interest, and costs that may accrue. /( I f.R7~1",~
Name of Taxpayer GH HOLDINGS INC
Residence 1130 WATERFORD
CAMP HILL, PA 17011-1229
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
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 defined
in IRC 6325Ia).
Tax Period Date of Last Dal. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
941 09/30/2004 52-2339227 01/31/2005 03/02/2015 5002.77
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Place of Filing
Prothonotary
Cumberland County Total $ 5002.77
Carlisle, PA 17013
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This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
05th day of August
2005
Signature
Title
ACS
(800) 829-3903
23-00-0008
for L LEDER
(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 66B(Y)(c) IRev. 2-20041
CAT. NO 60025X
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