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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 -JtO(~ 30~ FTL
Lien Unit Phone: (800) 829-3903 230174973
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
property belonging to this taxpayer for the amount of these taxes, and (') C:J
additional penalties, interest, and costs that may accrue. c' --- 0
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Name of Taxpayer JEFFREY D SEALOVER 2r~~'] -<
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Residence 345 GETTYSBURG PIKE ::;.-:;; -- 2:'" ' "-r',
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MECHANICSBURG, PA 17055-5171 J'>2: -. ,.:;: ;~o5
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, c~loq -< '- :0
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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 titt I \l "S\
in IRe 6325{a).
Tax Period Date of LastD?; for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1995 162-48-2443 09/16/1996 10/16/2006 2657.56
1040 12/31/1996 162-48-2443 05/19/1997 06/18/2007 3118.18
1040 12/31/1997 162-48-2443 07/06/1998 08/05/2008 3155.56
Place of Filing
Prothonotary Total $
Cumberland County 8931.30
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the
08th day of May
2001
Signature
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Title
ACS
23-01-0008
for L G DOWD (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,8, 4091 Form 668(Y)(c) (Rev, 10,00)
Part 1 - Kept By Recording Office . CAT. NO 60025X
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