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HomeMy WebLinkAbout05-6004 1872 Department of the Treasury - Internal Revenue Service Form 668 <Y)< c) Notice of Federal Tax Lien (Rev. February 2004) 7u,. OS' - {. OV '( Fn... Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS/SELF EMPLOYED AREA #3 Ii P..1( , /<i .<'1) Lien Unit Phone: (800) 829-3903 259135305 As provided by section 632', 6322, and 6323 of the Internal Revenue Ur.. /P " Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the fOllowing-named taxpayer. We have made 12t""" /'1/iIv 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. 0 ...., 0 c":' ~. c:~ .1 Name of Taxpayer SCOTT E SHIRK ':..", " ....,- ::::l i C) .:L.,.., I I) ;::;~~ -..: t'.CJ C/, N '" Residence 105 BUCHER HILL RD # 1 . - i t,"": C) BOILING SPRGS, PA 17007-9602 ::-~ .-" -' .} ;-) , - <'5fT1 -- 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, -,. ~~~j - .< 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 Refiltng of Assessment (a) (b) (c) (d) (e) (f) 1040 12/31/2001 190-56-5845 05/31/2004 06/30/2014 4255.91 1040 12/31/2002 190-56-5845 05/31/2004 06/30/2014 8962.36 1040 12/31/2003 190-56-5845 05/31/2004 06/30/2014 8454.53 1040 12/31/2004 190-56-5845 08/01/2005 08/31/2015 5626.30 Place of Filing prothonotary Cumberland County Total $ 27299.10 Carlisle, PA 17013 This notice was prepared and signed at PHILADELPHIA, PA I on this, the 11th day of November 2005 for L LEDER af/~ Title ACS (800) 829-3903 23-00-0008 Signature (NOTE: Certificate of officer authorized by Jaw to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B, 4091 Part 1 - Kept By Recording Office Form 668(Y)(c) IRev. 2-20041 CAT. NO 60025X