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499 Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. August 1997)
District Serial Number For Optional Use by Recording Office
PENNSYLVANIA 230061730
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) (") C~}
have been assessed against the following-named taxpayer. We have made c c;
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a demand for payment of this liability, but it remains unpaid. Therefore, ;:g F? ;"['1
there Is a lien in favor of the United States on all property and rights to 2.::~ -"CJ
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property belonging to this taxpayer for the amount of these taxes, and en "- n:-,
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additional penalties, interest, and costs that may accrue. r< "T': ',..
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Name of Taxpayer JOHNNY D & VICKIE L GILBERT ~,,-~
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Residence 3506 GREEN ST ::/fCX!rfo/00 PT-~
CAMP HILL, PA 17011-4318
IMPORTANT RELEASE INFORMATION: For each assessment listed below, crrtt J533(J~
unless notice of the lien is refiled by the date given in column (e), this notice shall, kf f OOt7/'
on the day following such date, operate as a certificate of release as defined
in IRe 6325(a). ' '
Tax Period Date of Last D~ for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilng of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1996 226-56-1676 12/28/1998 01/27/2009 9422.49
,
Place of Filing
Prothonotary Total $ 9422.49
Cumberland County
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
,011 this,
the
23rd day of . August
2000
Signature
for LOIS DOWD
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Title
ACS 23-01-0008
(MOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ru!. 71-466, 1971 - 2 C,B. 4091 Form 668(Y)(c) (Rev, 8-97)
Part I . Kept By Recording Office CAT. NO 60025X
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1008 Department of the Treasury. zernal Revenue Service
Form 668 (Z)
(Rev, 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recording o.ffice
SMALL BUSINESS/SELF EMPLOYED AREA #3 t&(. 17'-11 K.5. tJi)
Lien Unit Phone: (412) 395-5265 230061730
I certify that the following-named taxpayer, under the requirements of section 6325 (a) ~5l}r
of the Internal Revenue, Code has satisfied the taxes listed below and all statutory ~ /<I/.;1rtd
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on September 08
2000 , is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer () 0 0
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JOHNNY D & VICKIE L GILBERT " """
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Residence 3 5 0 6 GREEN ST r:- ~ :::'c:)
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CAMP HILL, PA 17011-4318 ~~~:~- -._P -,:;:"
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COURT RECORDING INFORMATION: :2:. ,. ~~
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Liber Page DCC No. Serial No. -( (~ -<
n/a nla n/a 00-6158 FTL ./
Tax Period Date of Last D'lf. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1996 226-56-1676 12/28/1998 01/27/2009 9422.49
******** '***********' ************* **********-J ************ ****************
Place of Filing
Prothonotary
Cumberland County Total $ 9422.49
Carlisle, PA 17013
This notice was prepared and signed at
Philadelphia, PA
, on this,
the
06th day of August
2003
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Title Compliance Technical Support
Manager
(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, Rul. 71-466,1971 - 2 C.B, 409) Form 668 (Z) (Rev, 10-2000)
Part I - RECORDING OFFICE CAT. NO 600261
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