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Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Fonn 668 (Y)(C)
(Rev" August 1997)
District
Serial Number
For Optional Use by Recording Office
PENNSYLVANIA 230062117 W-CO- Ud86'-Ttr
As provided by section 6321, 6322, and 6323 of the Internal Revenue tI' . _ {-
Code, we are giving a notice that taxes (including interest and penalties) g g ~
have been assessed agaunst the following-named taxpayer. We have made ,~ <n:"
a demand for payment of this liability, but it remains unpaid. Therefore, I,g] !:ti~t;~
there is a lien in favor of. the United States on all property and rights to - , ',5; ::: ::88
property belonging to thiS taxpayer for the amount of these taxes, and e ~ 9(:'
additional penalties, interest, and costs that may accrue. ~8 ;jf ~.~
Name of Taxpayer DAVID S & LORI A MOYER ~~ N b~
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PI /6///1
Residence
215 MAPLE AVE
CAMP HILL, PA 17011-4123
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
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
in IRe 6325(a).
Kind of Tax
(a)
1040
1040
Tax Period
Ending
(b)
12/31/1997
12/31/1998
Identifying Number
(c)
175-48-6900
175-48-6900
Date of
Assessment
(d)
OS/25/1998
06/17/1999
Last Day for
Refiling
(e)
06/24/2008
07/17/2009
Unpaid Balance
of Assessment
(f)
3964.76
2384.27
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
6349.03
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
26th day of .August
2000 .
the
. "
Signature
for LOIS DOWD
Title
ACS 23-01-0008
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev, Rul. 71-466, 1971 - 2 C,B. 409) Form 668(Y)(c) IRev. B-971
Part 1 - Kept By Recording Office CAT, NO 60025X
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1445 Department of the Treasury - Internal Revenue Service
Fonn 668 (Z) Certificate of Release of Federal Tax Liel1l
(Rev. 10-2000l
Area: Serial Number For Use by RecordinQ Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 -Ptt Pw cS: <rJ
Lien Unit Phone: (412) 395-5265 230062117
I certify that the following-named taxpayer, under the requirements of section 6325 (a) Ck. 196
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 '1 Y'35
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on September 14
2000 , is authorized to note the books to show the release of this lien for
, these taxes and additions.
Name of Taxpayer ,~ "'" 0
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DAVID S & LORI A MOYER --
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Residence 215 MAPLE AVE c:.'; . <Jl
CAMP HILL, PA 17011-4123 -"i..--n
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COURT RECORDING INFORMATION: :2 -- '~',
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Liber Page UCC No. Serial No. -' t..r'1 ':<
n/a n/a n/a .< N
00-6288
Tax Period Date of Last Dra; for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1997 175-48-6900 OS/25/1998 06/24/2008 3964.76
1040 12/31/1998 175-48-6900 06/17/1999 07/17/2009 2384.27
******** **********'ir. ************* **********'ir. ************ ****************
.
Place of Filing
Prothonotary
Cumberland County Total $ 6349.03
Carlisle, PA 17013
This notice was prepared and signed at
Philadelphia, PA
, on this,
01st day of April
2004
the
Sig
ture ~
,ur1li1f'~
f?
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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, 4091 Form 668 (Z) (Rev, 10-20001
Part t - RECORDING OFFICE CAT. NO 600261