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2879
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. October 20001
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 1/(;0---670 [) r:- r--,---
Lien Unit Phone: (412) 395-5265 230068472
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
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and rights to () 0
property belonging to this taxpayer for the amount of these taxes, and c: Cl 0
:s:: "
additional penalties, interest, and costs that may accrue. -Ow 0 :-=J
11IrT! "1
Name of Taxpayer ROSALEE MEALS 2:;1'''J' r) r'h:J::!
2C" N r--
('i.>.J;-" '--:f'n
r>-' 0 .~VO
:0<0 "'" ?;c:,
Residence 1752 SHEEP FORD ~C:J =:: ~~~;
j;O '2
MECHANICSBURG, PA 17055-4848 S;; Om
f)9. ()0 ~ -.,
(..) ~
--
IMPORTANT RELEASE INFORMATION: Foreach assessment listed below, -<
unless notice of the lien is refiled by the date given in column Ie). this notice shall, t~fl5 ?fJ(JS PFi6~?J~J
on the day following such date, operate as a certificate of release as defined
in IRC 6325Ia).
Tax Period Date of Last D'f. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi 109 of Assessment
(a) (b) (c) (d) (e) ef)
1040 12/31/1996 168-36-7708 09/22/1997 10/22/2007 1641. 68
1040 12/31/1997 168-36-7708 07/27/1998 08/26/2008 2891. 00
1040 12/31/1998 168-36-7708 04/24/2000 OS/24/2010 5317.45
,
Place of Filing
Prothonotary Total $
Cumberland County 9850.13
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
04th day of December
2000
the
Signature (/ tdiit.4- a LJ..'
for LOIS DOWD ~
Title
ACS
23-01-0008
(800) 829-3903
(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.8. 409)
. Part I - Kept By Recording Office
Form 668(Y)(c) IRev. 10-001
CAT. NO 60025X
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