HomeMy WebLinkAbout05-4606
1872
Department of Ihe Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) fl. Ii ,- - YG, (J(. F T L
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 4. /)11 r/'1.(,".J
Lien Unit Phone: (800) 829-3903 245041105
As provided by section 6321, 6322, and 6323 of the Internal Revenue c.k.- I Y 0
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made t?u. /(d3/7
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all propeny and rights to
propeny belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
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Name of Taxpayer RANDY E CaMERER C;:::J .~
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Residence 1477 WOODS RD r . rT'
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SHIPPENSBURG, PA 17257-9234 _1 I
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, - fTj
(~:,,)
unless notice of the lien is refiled by the date given in column (e), this notice shall, en
on the day fOllowing such date, operate as a certificate of release as defined C)
in iRC 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilmg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1998 199-50-8972 07/12/1999 08/11/2009 782.27
1040 12/31/2002 199-50-8972 06/02/2003 07/02/2013 1787.18
1040 12/31/2003 199-50-8972 06/07/2004 07/07/2014 4219.62
Place of Filing
Prothonotary
Cumberland County Total $ 6789.07
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
25th day of August
2005
the
Signature
Title
ACS
(800) 829-3903
23-00-0008
(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 t - Kept By Recording Office
Form 668(Y)(c) IRev. 2-20041
CAT. NO 60025X