HomeMy WebLinkAbout95-01477
Form 668 (V) G3.) Deparlmanl of tha Treasury. lnlarnsl Revenue Service
iAI"', October t993) Notice of Federal Tax Lien
District Serial Number For apI/ana' Use by Recording Olliee
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As provided by sections 6321, 6322, and 6323 of the Internal' Revenue :3::
Code, we are giving a notice that taxes (Including Interest and penalties) .-, :;: .~
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have been essessad against the followlng.named taxpayer. We have made '"
a demand for payment of this lIeblllty, 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 tha amount of thesa taxes, and " c;::>
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eddltlonal panaltles, Interast, and costs that may accrue. ~ :~: :,..;./ Q
Name of Taxpayer ;.. _ ,...~ t"" s:ao
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JARED , - L 08[1;:[.1 ;;;t' -
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Residence
1123 NAN rUOT T ;11,' -
MECHANICSBURG. 1-' ~ 1 ,(.l'.:,'::~._ ;;r,U4
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, 1lq, 00 pd
unless notice 01 lien Is reliled by the date given In column (e), this notice shall,
on the day lollowlng such date, operate as a certlllcate 01 release as dellned ,"u 7QlN.:J.
In IRC 63251al. Rli ~3'5~'f
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ended Identifying Number Assessment Reflllng of Alalaamlnt
(a) (b) (c) (d) (e) (f)
1040 12/31/1'0' 05' ". J4 -1 ')1:",;:' ')'J/24/'30 lU/.~4/00 12885.50
1040 12/31/81 05'0'.34- 1 ";.(.G ,:"9/24/90 111/24/00 16796.95
1040 12/31/82 OS'J-34-156E, 09/24/90 10/24/00 2386.17
1040 12/31/83 OS':! - 34 - 1 '31~13 1)9/24/90 11)/24/00 1321.11
1040 12/31/84 OS~)- 34-156E. ')~1/:4/'30 1/)/24/00 703.21
1040 12/31/85 OS,] 34-151:'.5 1)9/24/80 lU/24/I)O 1178.08
Place 01 Filing
Prothnnotarv Total $
CUIOb;,rland Qun t:,! 35271.0:
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This notice was prepared and signed at r .
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, on this,
the 1': tI, day 01 I ,
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Signature
Title
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(NOTE: Corlllica1o 01 allieor ilu1horizod by law 10 lako acknowludgmenl!. IS nol ossonll,1110 tho validity ot Notice at Foderal TOll lien
Rov. Rul. 71.466, 1971 .2 c.a. 409)
Part 1 . Kept By Recording Olllce
Form 668 (V) (Rev. 10-93)
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