HomeMy WebLinkAbout05-5192
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) 7U, 05'- 5'/9.2 rTl-
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 fJd . jJ -1f ' !<f&o
Lien Unit Phone: (800) 913-6050 249412105
As provided by section 6321, 6322, and 6323 of the Internal Revenue Dc 'f~'fO
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made , I(,n~~
a demand for payment of this liability, but it remains unpaid. Therefore, fLu...
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 c- = 0
c;\'
additional penalties, interest, and costs that may accrue. . Ln ."
_. C) --l
EFFECTS FOR C) :r: -r,
Name of Taxpayer SPECIAL HAIR -~': Tilr
I -;,m
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Residence 3507 MARKET ST STE 101 'i =.':'
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CAMP HILL, PA 17011-0000 - , (,jr-il
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, W .<
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 IRe 6325(a).
Tax Period Date of Last D?; for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
941 03/31/2005 23-2481482 06/27/2005 07/27/2015 6700.42
Place of Filing
Prothonotary
Cumberland County Total $ 6700.42
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 22nd day of September, 2005
for DARLENE
tl f/~
Title
REVENUE OFFICER
(717) 221-3490
23-09-1439
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,8, 409)
Part t ' Kept By Recording Office
Form 668(Y)(c) (Rev. 2,20041
CAT. NO 60025X