HomeMy WebLinkAbout06-6775
11799
Form 668 (Y)(C)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
ThD{,. (, 77~ ;=: rL
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 328884106
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 VERNA DENTAL SERVICES INC
For Optional Use by Recording Office
I!J. P1fL/l/;Lrf>
Q /:<.3SD
f1-. / fs' f L 9
(')
C
__:5::
"'ClJ
E2 [fl
zf.
(J)):
:-<'7
r-: t'
~ --
.l>C
?-=d
>c
~
Residence
235 HERMAN AVE
LEMOYNE, PA 17043-1938
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 IRC 6325(a).
Kind of Tax
(a)
1120
Tax: Period
Ending
(b)
09/30/2005
Identifying Number
(c)
25-1799203
Date of
Assessment
(d)
08/07/2006
Last Day for
Refiling
(e)
09/06/2016
Unpaid Balance
of Assessment
(f)
6780.75
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
This notice was prepared and signed at
DETROIT, MI
the
16th day of November
2006
Signature
Title
ACS
(800) 829-3903
22-00-0008
for REGINA OWENS
f'.,)
g
~
:::Ie
o
"<
N
CD
Q
~:n
~~
E5~i
~~
~
-<
:J:lIo
::c
'9
t'\.)
o
6780.75
, on this,
Part 1 - Kept By Recording OffIce
(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)
Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X
--*--
7116
Department of the Treasury - Internal Revenue Service
Certificate of Release of Federal Tax Lien
Form 668 {Z}
(Rev. 10-2000)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 328884106
I certify that the following-named taxpayer, under the requirements of section 6325 (a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on November 28
2 006 ,is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer
VERNA DENTAL SERVICES INC
Residence 235 HERMAN AVE
LEMOYNE, PA 17043-1938
Liber
n/a
COURT RECORDING INFORMATION:
UCC No. Serial No.
n/a 06-6775FTL /
Page
n/a
For Use by Recording Office
~. PJ-f/ g ~-.Op
t..k... </ ~ tJ )
~ /f?,3~1
o
c.
.- :<~:
f-~ }i
.. '.:,
c::
':
~
=
=
-...l
""Tl
rrt
c;o
N
co
o
.,
:r
m:D
..
um
:fJO
qCl
:1::'8
"~o
;~m
::::j
~
_D
-<
::c-
-
....t:.
CD
~
Ci
Tax: Period
Kind of Tax Ending Identifying Number
(a) (b) (e)
1120 09/30/2005 25-1799203
*******************~*************
Date of Last Day for
Assessment Refiling
(d) (e)
08/07/2006 09/06/2016
**********~************
Unpaid Balance
of Assessment
(f)
6780.75
****************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
DETROIT, MI
the 14th day of February , 2007
Signature
Title Director, Campus Compliance
Operations
Total $
6780.75
, on this,
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409)
Part 1 - RECORDING OFFICE
Form 668 (Z) (Rev. 10-2000)
CAT. NO 600261