HomeMy WebLinkAbout06-2588
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax: Lien
iRev. February 20041 J1.".O/" ~CH r:-rL
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1 rei.. fJ 1f I Jl/./I7)
Lien Unit Phone: (800) 829-7650 285119706
As provided by section 6321, 6322, and 6323 of the Internal Revenue c.k... .3vs'f
Code, we are gIvin, a notke that taxes (Includln, Interest and penakles) , /
have been assessed a,alnst the foUowIn,-named taxpayer. We have made & 1775":';
a demand for paymenc of this liability, buc ic remains unpaid. Therefore,
chere Is a lien In favor of the United Staces on all property and rights Co
property belonllin, Co chis taxpayer for the amounC of chese taxes, and
additional penalties, InCerest, and costs chac may accrue. (") ....,
= ~
Name of Taxpayer CLYDE M BURNHAM c: =
s:: .....
""Om :x ~f!?
mrn :I>
Z:r1 -<
Residence Zs,. I j3m
111 MAY DR APT 5 ~:~:~ en '?6
CAMP HILL, PA 17011-5023 ~C': ~...,.,
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, ~ r:-? ~
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(.).
Tax Period Date of Last D"If. for Unpaid Balance
Kind of Tax Endln, ldentifyin, Number Assessment Reft n, of Assessment
(a) (bl. Ce) Cd) (e) (fl
1040 12/31/1998 XXX-XX-0045 02/28/2005 03/30/2015 2919.97
Place of Filing
Prothonotary
Cumberland County Total $ 2919.97
Carlisle, PA 17013
This notice was prepared and signed at
DETROIT, MI
I on this,
the
18th day of April
2006
Signature
Title
ACS
(800) 829-7650
11-00-0000
for DEBRA K. HURST
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ru!' 71-466.1971.2 C.8. 409)
Part 1 . Kept By Rec:onllnr Office
Form 668(Y)(c) (Rev, 2.2004)
CAT. NO 60025X