HomeMy WebLinkAbout06-3758
1872
Form 668 (Y)(c)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
- 375; FTL
(Rev. February 2004)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 299015006
As provided by section 632., 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 DAVID R YODER
For Opti<;mal Use by Recording Office
-P,L. (J 11 ~ 11/ .00
cL !In'!
~ 1?9fOA-
<--,
C:::J
0:..;;,....
.-1
,J;
Residence
1422 BRADLEY DR 313
CARLISLE, PA 17013-1276
,..,
o
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shatl,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
:'17
t,"~ ...,,,,
Kind of Tax
(a)
941
Tax Period
Ending
b)
09/30/2004
Identifying Number
(c)
25-1832274
Date of
Assessment
(d)
08/15/2005
Last Day for
Reflllng
(e)
09/14/2015
Unpaid BalaJlce
of Assessment
(
1501. 84
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
1501. 84
This notice was prepared and signed at
DETROIT, MI
, on this,
the
23rd day of June
2006
Signature
Title
REVENUE OFFICER
(717) 221-3490 x1320
22-06-1442
for DAVID M. SHROYER
(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. 409)
'art I - Kept By Rocordln. Office
Form 668(Y)(c) IRev. 2-2004)
CAT. NO 6OO25X