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4251
Department of the Treasury - Intemal Revenue Service
Form 668 (Y)(C)
(Rev. February 2004)
Notice of Federal Tax Lien
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For Optional Use by Recording Office
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Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 318693906
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 TERRY E FREEMAN
Residence
1219 HIGHLANDER WAY
MECHANICSBURG, PA 17050-8302
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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,
on the day following such date, operate as a certificate of release as defined
in IRe 6325(a).
Kind of Tax
(a)
1040
1040
1040
1040
1040
1040
Tax: Period
Ending
(b)
12/31/1996
12/31/2001
12/31/2002
12/31/2003
12/31/2004
12/31/2005
Identifying Number
(c)
XXX-XX-7223
XXX-XX-7223
XXX-XX-7223
XXX-XX-7223
XXX-XX-7223
XXX-XX-7223
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
Date of
Assessment
(d)
11/16/1998
02/06/2006
09/19/2005
09/19/2005
09/19/2005
07/31/2006
DETROIT, MI
Last Day for
Refillng
(e)
12/16/2008
03/07/2016
10/19/2015
10/19/2015
10/19/2015
08/30/2016
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Unpaid Balance
of Assessment
(f)
10428.22
20088.51
5447.73
70097.28
48980.60
33333.87
Total $
188376.21
, on this,
the
22nd day of
September 2006
,
Signature
for REGINA OWENS
Title
ACS
(800) 829-3903
22-00-0008
(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)
Part 1 - Kept By Recording Office
Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X