HomeMy WebLinkAbout06-2867
1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien J'L;.{Jr.. ;[f(. '7
(Rev. February 2004) Fn
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2 Ii P4( "1'I,1f'/)
Lien Unit Phone: (800) 829-3903 289591506
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck.. 'I 'III
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made t2....-. n f/(, 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 property and rights to
property belonging to this taxpayer for the amount of these taxes, and 0 .....,
additional penalties, interest, and costs that may accrue. = 0
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Name of Taxpayer DAVID MILLER JR .-
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Residence '" C.) ....
5 CREEK RD ;~~~
CAMP HILL, PA 17011-7412 "'"
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IMPORTANT RELEASE INFORMATION: For each assessment listed below. -i .::- 55
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unless notice of the lien is refiled by the date given in column (a), this notice shall, CO .<
on the day following such date, operate as a certificate of release as defined
in IRe 6325(a).
Tax Period Date of Last Dra; for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi ng of Assessment
(a) Cbl (c) Cd) (el en
1040 12/31/2001 XXX-XX-1398 06/06/2005 07/06/2015 5498.15
Place of Filing
Prothonotary
Cumberland County Total $ 5498.15
Carlisle, PA 17013
This notice was prepared and signed at
DETROIT, MI
, on this,
the
09th day 01 May
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
Part t - Kept By Recording 0fIke
Form 668(Y)(c) IRev. 2-2004)
CAT. NO 60025X