HomeMy WebLinkAbout95-05034
"
!
>
- 63
I
!
;
!
...
\ ,
,
. .- '-
D.partm.nt olth. Tr.asury - Intornol Revenue Servlc.
orm 668 (V) (c) '" ,
1t)\. Ckll)twr Hh),J)
Notice of Federal Tax LIen
For Opl/onal Usa by Recording Olllce
As provided by sections 6321, 6322, and 6323 of the Internal Revenue
Code, we ara giving a notlc. that taxes (Including Interest and penalties)
have been ass....d against the followlng.named taxpayer. We have made
. demand for paym.nt of this liability, but It remains unpaid. Therefore,
there II a lien In favor of the United States on all property and rights to
property belonging to thll taxpayer for the amount of these taxes, and
additional penalties, Interest, and costs that may accrue.
lame of Taxpayer
DAV lD L EVANS
IMPORTANT RELEASE INFORMATION: For each assessment listed below.
unless notice of lien is reflled by the date given in column (e). thiS notice shall.
on the day following such date. operate as a certificate of release as delined
in IRC 6325(a).
Tax Period
Ended
(b)
Serial Number
lesldence
,'311) BROOI, RD
CAMP HILL. PA 17011-IS11
Kind of Tax
(a)
Identifying Number
(c)
. 1.1
jl((rj rj.~,)L~
F'iL
I~-"l
'~
r-. "
r-
C"
...
:..
<.D
V1
ll':lL.; ". ~
<.....\ 11 .~~ .~~~, K.!i
;} '.h'>L;
Date of
Assessment
(d)
Last Day for
Reflllng
(e)
Unpaid Balanc.
of Assessm.nt
(f)
. . - , ~ i .:
- ~ . ',lo.l
_'~'r;::.':1 . -4 -:
1':'/31/':,14
1 :;:~. - 41_1- '~I~-; -'4 ~~>,' :::t'i,' -,-'t
18~-4,')-~~,'~4 .-~ ~':" ~~
;.. '1'-,
j ')4.-)
1 '",4('
1.- I ~: 1 . . , ;:
lace of Filing
~>, ,)th~lfl,-.t3.l.
t. umt..@t I al1'1 (';\.11':'.
. t liS If:", ~.' A 1" :
his notice was prepared and signed at
Ie ~~. fl.j day of AU'HJ~ t
. 19 --.:.. '
Ignature
. ......_~e: '1. l".,.\f~ ~~\:."". I
Total S
~J _ ~_ . .1 "
.
. on this.
~
(NOTE: C,rtiIlC". of offiCI' lloltnOfllld bV lay, 10 tioke a.:~n;,;"leailm.!"!ls \1 net h'itn!,itlto thl walldt1v of Notlcl of Fldlral Tllllln
Rov Ru~'466 '971,2 C B 409)
~J . . 0"." 9;}'tl . Kept By Recording Ollice Form 668 (V) (c) (Rev 10/93)
I T.lle
"11
,..
,..
,...
...
.
.
...
. .
...
.
-
. .
. .
.
. .
..'
."
....
Form 6681Z) Department 01 the Treelury . Inlernel Revenua Service
(Rev B-971 Certificate of Release of Federal Tax Lien
DI.trlct Serlel Number For U.e bv Recordlna Olllce
I certify thet the followlng.nemed taxpayer, under the requlrementa of .ectlon 6325 (a)
01 the Internal Revenue Code haa aatl.f1ed the taxe. 1I.led below and all .tatutory
addltlona. Therefore, the lien provided by Code aectlon 6321 lor the.e taxel and , ,
addltlona has been relaased. The proper olllcer In the olllce where the notice of ' ~
Internal revenue tax lien waa flied on ,
, l
, I. authorized to note the booka to ahow the release 01 thl. lien for , -
the.e texe. and addltlona. ,
Name 01 Texpayer
- , ,1'(
..
.. ,
Realdence -0 ,l
f; . .
1\ .s '-~L'\ ,\
(,_" d lq .j"::.::l4
~'t\ '-"4'>11
Kind 01 Tax Tax Period Ended Identifying Number Dete of Laat Day for Unpaid Balance of
(8) (b) (e) As..asment Reflllng As_sment
(d) (e) (f)
Place of Filing
Total S
This notice was prepared and signed at _.__.__
_ . on this.
the
day of
Signature
/-'
I Title
\N()T~ l~I'/rd;( .HI' ,", ""'-1" ,1,,1',,'I,:et1 t'lv 1"1\ to la"'" aCllfl(ll\lt"I1gmf"H~ ,s '''It t'$.St;lllt",1 ri.-1lhe ~"I't1If) ()f Ce'td,,:at8 t;f ReltMSB 01 F""iJ/ rot. httn R~ Rul 71-468. 1971.2 CB 409J
PART' - RECOROING OFFICE
Form'" (l) (Rev 8.97l
CAT NO 600261