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Form lIlIi! (V) Ie)
(Rov, AUO".I I UU 71
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Dl>p.>r1rrnml ollho TrODlUry . Inl0rnol Rovonuo Service
Notice of Federal Tax Lien
DI.lI1Cl
PENNSYl.VANIA
Sorlal Number
For Optlona' U.. by RoeonJlng 0tI1H
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. AI provided by seellonl 6321, 6322. and 6323 01 the Internal Revenue
Code, wa are giving a nollce thattaxel (Including Interest and penallles)
have boen assessed agslnstthe lollowlng.named taxpayer. We have made
a demand lor payment 01 this lIablllly, bUI It remains unpaid, Therelore,
there II a lien In lavor 01 the United States on all property and rights to
property belonging to this taxpayer lor the amount 01 these taxes, and
addlllonal penallles, Interest, and costs that may accrue.
Namo olTaxplyor LEON C & DOR I S [JAKF:R
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Realdoneo
4940 SIMPSON FERRY RO
MECHANICSBURG, PA 17055-3630
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Kind olTax Tax Period Ended Idanlllylng Number Date 01
Assessmenl
(/I) (b) (c) (d)
1040 12/31/1995 186-28-3654 OS/20/1996
1040 1213111996 186-28-3654 05119/1997
1040 1213111997 186-28-3654 06/08/1998
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eA.lo.I' \<\-;)<n'(1
~kl'l'-lU5'S
Lasl D/lY lor Unpaid Balance 01
Rellllng Assessment
(e) (f)
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
u~less notice of lien Is refiled by the dale 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),
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06119/2006
06118/2007
07/08/2008
Placo of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
$
, , ,Pittsburgh, PA
ThiS notice was prepared and Signed at
the 06thqay of
November
1998
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BE'iLE ,)i:'iIS'KT:AC"S'" ,.
Title
MANAGER 23-01-0000
(NOTE: Cortifica/e of officor authorizod by "lW 10 take DCknowlodgments is not essentiflllo tho viJlidily of Notlco of Federal Tax lien Rev. Rul. 71-466, 1971.2 C.B. 409)
PART 1 . KEPT DY RECORDINO OffiCE
Form 668 (V) (e) (Rev, 8-97]
CAT, NO 60025X E);":