Case 3:07-cv-02187-IEG-NLS
Document 18-6
Filed 01/11/2008
Page 1 of 8
United States
of America
Department of the Treasury Internal Revenue Service
Date:
Dec. 28, 2007
CERTIFICATE OF OFFICIAL RECORD
I certify that the annexed: is a true Form 4340, Certificate of Assessments, Payments and Other Specified Matters for Roosevelt Kyle, SSN: 3335, for Civil Penalty, for the tax period
ending December 3 J, J 983, consisting of three pages . dm___ ----.------ ------
under the custody of this office.
IN WITNESS WHEREOF. I have hereunto set my hand,
and caused the seal of this office to be affixed, on the day and year first above written.
~XAJ~
Supervisor Accounting Technician Ogden W&I Submission Processing SW Delegation Order J 98
89 Exhibit E Catalog Number 19002E
By direction of the Secretary of the Treasury:
Exhibit E
Form 2866 (Rev 09-1997)
- - - -- - - - - - - - - --- - - - - - - - - -- - --- - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - --- - - - - ---
Case 3:07-cv-02187-IEG-NLS Document 18-6 Filed 01/11/2008 Page 2 of 8 CERTIFICATE OF ASSESSMENTS, PAYMENTS, AND OTHER SPECIFIED MATTERS
ROOSEVELT KYLE EIN/SSN:
TYPE OF TAX: CIVIL PENALTY
FORM: CVPN TAX PERIOD: DEC 1983
DATE
DATE (23C, RAC 006 ) - - - - - - - - - - - - - ----- - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - -- - - - - - - - - - --- - - - - --EXPLANATION OF TRANSACTION
CREDIT (REVERSAL)
ASSESSMENT, OTHER DEBITS (REVERSAL)
PAYMENT,
ASSESSMENT
QUICK ASSESSMENT IRC 6694 PENALTY UNDERSTATEMENT OF TAX BY PREPARER
600.00
08
o .00
04-06-1987
33251-096-13210-7
QU ICK ASSESSMENT 33251-096- 13210-7
04-06-1987 06-08-1987
08
INTEREST ASSESSED
9.39
19872108
04-01-1988 FEDERAL TAX LIEN
04-27-1988 FEDERAL TAX LIEN
04- 14- 1997 STATUTE EXPIRED -
609.39
CLEAR TO ZERO UNCOLLECTABLE AMOUNT OWED
$ 609.39-
02-05-2007 FEDERAL TAX LIEN RELEASED
04-06- 1987 Statutory Notice of Balance Due
06-08-1987 Statutory Notice of Balance Due
07-13-1987 Notice of Balance Due 08-17-1987 Notice of Balance Due
FORM 4340
(REV. 01-2002)
PAGE
1
90 Exhibit E
Case 3:07-cv-02187-IEG-NLS Document 18-6 Filed 01/11/2008 Page 3 of 8 CERTIFICATE OF ASSESSMENTS, PAYMENTS, AND OTHER SPECIFIED MATTERS
ROOSEVELT KYLE
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - -- - - - - - - - - - - - - - - - - - -- - - - --
EIN/SSN:
TYPE OF TAX: CIVIL PENAL TV
FORM: CVPN TAX PERIOD: DEC 1983
DATE
DATE (23C, RAC 006 ) - - - - - - - - - - - - - - - - - - - - - - - -- - - - - -- - - - - - - - - - -- - - - - - -- - - - - - --- - - - - - - - - - -- - - - -EXPLANATION OF TRANSACTION
ASSESSMENT, OTHER DEB ITS
PAYMENT, CR EDIT
ASSESSMENT,
(REVERSAi)
(REVERSAi)
09-21-1987 Notice of Balance Due
10-19-1987 Statutory Notice of Intent to Levy
01-01-1990 Statutory Notice of Intent to Levy
FORM 4340
(REV. 01-2002)
PAGE
2
91 Exhibit E
- - -- - - -- - - - -- - - -- - - -- - -- -- - --- - -- - - -- - - - - --- - - -- - - --- - - - - - - --- - - - - --- - - -- - - - - - --
Case 3:07-cv-02187-IEG-NLS Document 18-6 Filed 01/11/2008 Page 4 of 8 CERTIFICATE OF ASSESSMENTS, PAYMENTS, AND OTHER SPECIFIED MATTERS
ROOSEVELT KYLE EIN/SSN:
TYPE OF TAX: CIVIL PENALTY
FORM: - - - - - ------ - PERIOD:-DEC - --- - -- - - --- - - - - - --- - - - - - -- - - -- - - - - - --- - -- - - -CVPN TAX - ---- --- - ---- - 1983 - - - -- -BALANCE
o .00
- - - -- - - - - - - - - ---- - - - - - -- - - -- - - - ---- --- - - - - - - - -- - - - -- - -- - - - --- - - -- - - - - - --- --- - - -I CERTIFY THAT THE FOREGOING TRANSCRIPT OF THE TAXPAYER NAMED ABOVE IN RESPECT TO THE TAXES SPECIFIED IS A TRUE AND COMPLETE TRANSCRIPT FOR THE PERIOD STATED, AND ALL ASSESSMENTS, ABATEMENTS, CREDITS, REFUNDS, AND ADVANCE OR UNIDENTIFIED PAYMENTS, AND THE ASSESSED BALANCE RELATING THERETO, AS DISCLOSED BY THE RECORDS OF THIS OFFICE AS OF THE ACCOUNT STATUS DATE ARE SHOWN THEREIN. I FURTHER CERTIFY THAT THE OTHER SPECIFIED MATTERS SET FORTH IN THIS TRANSCRIPT APPEAR IN THE OFFICIAL RECORDS OF THE INTERNAL REVENUE SERVICE.
- - - -- - - - - - - --- - - --- - - - - ---- - -- -SIGNATURE OF CERTIFYING OFFICER' Linda L. Drake PRINT NAME:
/
--- -- - ---------- . -------------- - - - - -- -- ---
TITLE:
Supervisor Accounting Technician, Ogden W&I Submission Processing
DELEGATION ORDER:
SW Delegation Order 198
LOCATION: INTERNAL REVENUE SERVICE
ACCOUNT STATUS DATE 12/28/2007
FORM 4340 (REV. 01-2002)
PAGE
3
92 Exhibit E
Case 3:07-cv-02187-IEG-NLS
Document 18-6
Filed 01/11/2008
Page 5 of 8
United States
of America
Department of the Treasury
Internal Revenue Service
Date:
Dec. 28, 2007
CERTIFICATE OF OFFICIAL RECORD
I certify that the annexed: is a true form 4340, Certificate of Assessments, Payments and Other Specified Matters for Roosevelt Kyle, SSN: 3335, for Civil Penalty, for the tax period
ending December 31, i 984, consisting of three pages - - ------------ - --- ------------
under the custody of this office.
IN WITNESS WHEREOF, I have hereunto set my hand,
and caused the seal of this office to be affixed, on the day and year first above written.
B~~cti~n of.the Secretary Of.
Linda L. Drake Supervisor Accounting Technician Ogden W&I Submission Processing
SW Delegation Order i 98
~~icc!\Lw
the Treasury:
93 Exhibit E Catalog Number 19002E
Form 2866 (Rev_ 09-1997)
- - - - - - - - - - - - - - - -- - - - - - - - - -- -- - - - - - - - -- - - - -- - - - - - - - - - - - - - - - - - - - - -- - - - - - - -- - - - - - --
Case 3:07-cv-02187-IEG-NLS Document 18-6 Filed 01/11/2008 Page 6 of 8 CERTIFICATE OF ASSESSMENTS, PAYMENTS, AND OTHER SPECIFIED MATTERS
ROOSEVELT KYLE EIN/SSN:
TYPE OF TAX: CIVIL PENALTY
FORM: CVPN TAX PERIOD: DEC 1984
OA TE
DATE (23e, RAe 006 ) - - - - - - - - -- - - - - - - - - - -- -- - --- - - - --- - - --- -- - - - - - - -- - - - - - - - - - - -- - - - - - -- - - - -- - - - - - - -EXPLANATION OF TRANSACTION
CREDIT (REVERSAL)
QU I CK ASSESSMENT
ASSESSMENT, OTHER DEBITS ( REVERSAi)
PAYMENT,
ASSESSMENT
600.00
08
o .00
04-06-1987
IRC 6694 PENALTY UNDERSTATEMENT OF TAX BY PREPARER
33251-096-13211-7
QU I eK ASSESSMENT
04-06-1987 06-08-1987
33251-096-13211-7
INTEREST ASSESSED
08
9.39
19872108
04-01-1988 FEDERAL TAX LIEN 04-27-1988 FEDERAL TAX LIEN
04-14-1997 STATUTE EXPIRED CLEAR TO ZERO UNeOLLECTABLE AMOUNT OWED
609,39
$ 609.39Notice of Balance Notice of Balance
(REV.
Due Due
02-05-2007 04-06-1987 06-08-1987 07-13-1987 08-17-1987
FORM
FEDERAL TAX LIEN RELEASED
Statutory Notice of Balance Statutory Notice of Balance
Due Due
4340
01-2002)
PAGE
1
94 Exhibit E
Case 3:07-cv-02187-IEG-NLS Document 18-6 Filed 01/11/2008 Page 7 of 8 CERTIFICATE OF ASSESSMENTS, PAYMENTS, AND OTHER SPECIFIED MATTERS
ROOSEVELT KYLE EIN/SSN:
TYPE OF TAX: CIVIL PENALTY
FORM: CVPN TAX PERIOD: DEC 1984
DATE
EXPLANATION OF TRANSACTION
ASSESSMENT, OTHER DEBITS ( REVERSALl
PAYMENT,
CRED IT
ASSESSMENT,
(REVERSAL)
DATE (23C, RAC 006 )
09-21- 1987 Notice of Balance Due
10-19-1987 Statutory Notice of Intent to Levy
01-01-1990 Statutory Notice of Intent to Levy
FORM 4340
(REV. 01-2002)
PAGE
~ '-
95 Exhibit E
Case 3:07-cv-02187-IEG-NLS Document 18-6 Filed 01/11/2008 Page 8 of 8 CERTIFICATE OF ASSESSMENTS, PAYMENTS. AND OTHER SPECIF lED MATTERS
ROOSEVELT KYLE EIN/SSN:
TYPE OF TAX: CIVIL PENALTY
FORM: CVPN TAX PERIOD: DEC 1984
BALANCE
o .00
I CERTIFY THAT THE FOREGOING TRANSCRIPT OF THE TAXPAYER NAMED ABOVE IN RESPECT TO THE TAXES SPECIFIED IS A TRUE AND COMPLETE TRANSCRIPT FOR THE PERIOD STATED. AND ALL ASSESSMENTS, ABATEMENTS. CREDITS. REFUNDS, AND ADVANCE OR UNIDENTIFIED PAYMENTS, AND THE ASSESSED BALANCE RELATING THERETO. AS DISCLOSED BY THE RECORDS OF THIS OFFICE AS OF THE ACCOUNT STATUS DATE ARE SHOWN THEREIN. I FURTHER CERTIFY THAT THE OTHER SPECIFIED MATTERS SET FORTH IN THIS TRANSCRIPT APPEAR IN THE OFFICIAL RECORDS OF THE INTERNAL REVENUE SERVICE.
- - -- - - - - - - - -- - - - --- - - - - - - - - --- - -~- - - - - - - - --- - -- - - - - - -- --- - - - - - ---- -- - - -- - ---
SIGNATURE OF CERTIFYING OFFICER: ~l jl~./ ~~. D~
PR INT NAME:
Linda L. Drake
T I HE: Supervisor Accounting Technician, Ogden W&I Submission Processing
DELEGATION ORDER:
SW Delegation Order 198
LOCATION: INTERNAL REVENUE SERVICE
ACCOUNT STATUS DATE 12/28/2007
FORM 4340 (REV. 01-2002)
PAGE
3
96 Exhibit E