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Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
Notice of Federal Tax: Lien
(Rev. October 2000)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 tco~ WOO+rL
Lien Unit Phone: (BOO) B29-3903 230067075
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made C)
a demand for payment of this liability, but it remains unpaid. Therefore, (:::
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there is a lien in favor of the United States on all property and rights to :O::c., -z !
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property belonging to this taxpayer for the amount of these taxes, and rnj":- -
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additional penalties, interest, and costs that may accrue. ~5~.:; i'.)
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Name of Taxpayer TONY G GRIMES ~t; ~!,'~)
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Residence 565 OPOSSUM LAKE RD z ::0 ~i>'
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CARLISLE, PA 17013-8928 00- 'D -<
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, ty1( f53b
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 Pf (jJ43Q3
in IRe 6325(0).
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::,., ' 12/31/1991 205-56-1550 03/22/1999 04/21/2009 3983.57
1040 12/31/1992 205-56-1550 03/22/1999 04/21/2009 10852.00
1040 ' 12/31/1993 205-56-1550 03/22/1999 04/21/2009 9209.19
1040 ',' ' 12/31/1995 205-56-1550 03/22/1999 04/21/2009 4818.05
1040 ' 12/31/1996 205-56-1550 03/08/1999 04/07/2009 5286.61
1040 ' 12/31/1997 205-56-1550 03/08/1999 04/07/2009 4729.70
1040 ; 12/31/1998 205-56-1550 05/31/1999 06/30/2009 2621.13
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Place of Filing
Prothonotary Total $
Cumberland County 41500.25
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
21st-dayof' October
2000
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Title
ACS
23-01-0008
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for LOIS DOwn-----'
(800) 829-3903
(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, 10-001
Part I - Kepc By Recording Office CAT. NO 60025X