HomeMy WebLinkAbout05-4604
1872
Form 668 (Y)(c)
Department of the Treasury - Internal Revenue Service
(Rev. February 2004)
Notice of Federal Tax Lien
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Area:
WAGE & INVESTMENT AREA #2
Lien Unit Phone: (800) 829-7650
Serial Number
For Optional Use by Recording Office
245726805
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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
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 DEREK M ROBBINS
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Residence
3521 SEPTEMBER DR APT 6
CAMP HILL, PA 17011-5059
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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 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refihng of Assessment
(a) (b) (c) (d) (e) (0
1040 12/31/2001 578-76-4836 06/03/2002 07/03/2012 2376.47
1040 12/31/2002 578-76-4836 08/04/2003 09/03/2013 3808.24
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
6184.71
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
30th day of August
2005
the
for P S
Title
ACS
(800) 829-7650
12-00-0000
Signature
(NOTE: Certificate of officer authorized by taw 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 t - Kept By Recording Office
Form 668(Y)(c) IRev. 2-20041
CAT. NO 60025X