HomeMy WebLinkAbout06-1873
1872
Form 668 (Y)(c)
Department of the Treasury - Internal Revenue Service
(Rev. February 2004)
Notice of Federal Tax Lien
770 0(" - If 7.3
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 280147006
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 JAY M WAY
For Optional Use by Recording Office
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Residence
1453 COCKLEYS MEADOW DR
BOILING SPRGS, PA 17007-9687
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IMPORTANT RELEASE INfORMATION: For each assessment listed below,
unless notice of the lien is rafiled by the date given in column (eJ. this notice shall,
on the day following such date, operate as a certificate of release as defined
in ]Re 6325(a).
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Kind of Tax
(a)
1040
Tax Period
Ending
(b)
12/31/1995
Identifying Number
(c)
XXX-XX-4835
Date of
Assessment
(d)
07/28/1997
Last Day for
RefilIng
(e)
08/27/2007
Unpaid Balance
of Assessment
(f)
4027.31
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
4027.31
This notice was prepared and signed at
DETROIT, MI
, on this,
the
21st day of March
2006
Signature
Title
ACS
(800) 829-3903
22-00-0008
for REGINA OWENS
(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. 4091
Pan 1 - Kept By Recording Office
Form 668(Y)(c) (Rev. 2-20041
CAT. NO 60025X