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499
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
IRev. October 2000) lie 0.2., (,,/'1/ r-: rL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 Ik Pi! ~ n,lP,;
Lien Unit Phone: (800) 829-3903 230299053
As provided by section 6321, 6322, and 6323 of the Internal Revenue Q Yil
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made Eu~, /330 JG
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 JEFFREY E DEITRICK & CAROL A MIX () 0
C' i'V 0
~:oo. '01
lJ ;j~~ 0
m;'1 ''-' ./
;;; )~ (J ' .
Residence 555 BROWNS LN 0'5 '; l'>J '.
"
ENOLA, PA 17025-2904 ;5 ~?~ -.../
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.):; ...... =
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, -..~
.::c; (0. t??
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 :::.J :n
in IRe 6325(a), "- ....1
Tax Period Date of Last D?; for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1999 171-54-1270 OS/21/2001 06/20/2011 6496.79
Place of Filing
Prothonotary Total $
Cumberland County 6496.79
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the
17th day of December
2002
(NOTE: Certificate of officer authorized by law to tak acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev, Ru!' 71-466, 1971 ' 2 C,B. 409)
Title
ACS
(800) 829-3903
23-00-0008
Signature ,,~. / .' .
for L ~J~
Part 1 - Kept By Recording Office
Form 668(Y)(c) IRev. 10-00)
CAT, NO 60025X
\
--*-- 1872 Department of the Treasury' Internal Revenue Service
Form 668 (Z) Certificate of Release of Federal Tax Lien
(Rev. 10-20001 I
,
Area: Serial Number For Use by Recordiric:i Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 Ik P J/I" 'S:t/'D
Lien Unit Phone: (412) 395-5265 230299053
I certify that the following-named taxpayer, under the requirements of section 6325 (a) Q130t,.
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 ~ 1(,.,~'I'If
additions has been released. The proper officer in the office where the notice of (') ....., 0
internal revenue tax lien was filed on December 27 =
~;:~ = -n
2002 en
, is authorized to note the books to show the release of this lien for ". ::",. ::;:I
..' -ry m~
these taxes and additions, ?J
- -orn
Name of Taxpayer l'v ;3'(
O:l
JEFFREY E DEITRICK & CAROL A MIX -.. ~, .1(.)
, :".I:=n
'"'"C !~~~
:r
- _,l
Residence 555 BROWNS LN ., "t:..
Ul ):J
ENOLA, PA 17025-2904 (",,, -<
COURT RECORDING INFORMATION:
Liber Page ace No_ Serial No.
n/a n/a nla 02-6141 FTL
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refillng of Assessment
(a) (b) (e) (d) (e) (f)
1040 12/31/1999 171-54-1270 OS/21/2001 06/20/2011 6496 _ 79
******** ************ ************* **********'11 ************ ****************
Place of Filing
Prothonotary
Cumberland County Total $ 6496.79
Carlisle, PA 17013
This notice was prepared and signed at
Philadelphia, PA
I on this,
the
13th day of April
2005
Signature
Title Director, Payment Compl iance
(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. Ru!. 71-466, 1971 - 2 C.B. 409)
Part 1 - RECORDING OFFICE
Form 668 (I) IRev. 10'20001
CA T. NO 600261