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Department of the Trellury . Internel Revenua Service
Notice of Federal Tax Lien
Serlel Number
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Idld by IIcllonl 8321, 8322, and 6323 01 Ihe Internal Revenue
, w. a,. giving a notice Ihal texll (Including Int.real and penalties)
, been al..Dlld agalnlt the lollowlng-named laxpayer. We have made
.mlnd lor paymenl 01 Ihll lIablllly, but It remalnl unpaid. Therelore,
, ... II . IIln In flvor 01 the United SteteD on all property and rlghll to
petty belonging 10 thll taxpayer lor the amcunl 01 thess laxes, and
dlllon.1 penalll.., Inleresl, llnd c08ta that may aoorue.
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For Optlon.1 U.. br!!.....ordlng 0III0f
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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 defined In
IRC 6325 a), fC II
Date 01 Lilt Day for
A.....m.nt R.flllng
(d) (e)
KInd OlTllx rax P.rlod Ended Identifying Numb.r
fa) (b) (0)
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(NOTE: CerlltlclIle of offlcBr sWlor/zod by law 10 IS/(8 lIcknowlildgmon's Is no! essfm,illl/o tho validity of No/lco of Fod6fllf Tllx lion Rev. Rllf. rt.48tl, 1971.2 G.B. "(l9)
PART 1 . KIPT BV Rr.COAOINQ O'''ICI
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Form eee IV) (e) (ROY, e-D7)
CAT NO 60025X
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--,,-- 1872 Doportmont of tho Troosury - Intornal Revenue Service
Form 668 (Z) Certificate of Release of Federal Tax Lien /
lAev, 10,2000)
Area: Serial Number For Usa bv Reoording Offioe
SMALl, BUSINESS/SELF b~MPL.OYED MEA 113 ,?t, f?Y( , s-' i/1)
Lien Unit Phone: (900) 913-6050 239840913
I cortlfv that tho followlno.nomod taxpovor, undar Iho raqulromenls of soctlon 6326 ( cA t... or
of tho Intornal ROl/onuo Codo hos satisfied the taxos IIstod bolow ond all statutory
additions, Th.rofor., tho lI.n prol/ld.d bv Codo 80ctlon V321 for those toxos and '2 n NIL
additions h.. boon ,010080d, Th. prop.r olfleor In Ih. ottlco whore tho notleo of (j ,....
Int.rnal 'al/onua lax lion was fIIod on ,_,"~____J\:p.E.Ll__g_~_____, "___"_~_"_'
___19.9..!._, I. autho,lzod to noto tho books to show tho roloaso of this lion for
thoso taxa. and additions,
Namo of T axgayer
RICHARD & LORI LYNN DERR
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Rosldonoe 7 MELWOOD LANE: 1'1 h'j L!
MECHANICSBURG, 17055-2319 '\J ,"
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COURT RECORDING INFORMATION: -,
Liber Page UCC No. Serial No, (.1
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n/a n/a n/a 98 -1871FTL .. ,
.'
Tax Period Date of Lait Dff. for Un,,~ B~ce:C.
KInd of Tax End'n. Idenlll'ylll. Number Assessment Ren Dr of Assessment
((11_ (bl (el (dl (el ffI
1040 12/31/1995 163-60..6211 07/29/1996 08/28/2006 3684,11
1040 12/31/1996 163-60-6211 05/19/1997 06/18/2007 5199.40
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Plaoe of Filing
Prothonotary
Cumberland County Total $ 8883.51
Carlisle, PA 17013
This notioe was prepared end signed at
Philadelphia, PA
~-._..,~~---_._-------------.._---
, on this,
the 24th day of August ,2005,
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Signaturo
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-
Title Director/campus Compliance
Operations
(NOTEl CortUiOllh, 01 offi{Jor ltUlhorllud hy IllW to IlIko IWKIlCiwlmlnmonts is 11II1 6!HlnnUlllw Ihn VAlidity of CurU'ionhl 0' AelQole of
flllll".1 Tn' IIn" AIll/, Aul. 71-466, 19-/1 ,2 C,8, 4091 Flllrn 661 (Z) IA.I/, 10,20001
Pin t . RECORDING OFFICE CA r, NO 60026'