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Form 668 <Y)< c) Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
(Rev. October 20001
Area: Serial Number For Optional Use by Recording Office
WAGE " INVESTMENT AREA #2 j()J~3J43
Lien Unit Phone: (800) 829-7650 230175279 Pr
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, c" ',-,,'
there is a lien in favor of the United States on all property and rights to ,"
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property belonging to this taxpayer for the amount of these taxes, and -:?""
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additional penalties, interest, and costs that may accrue. S2~;-, - "
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Name of Taxpayer DAVID GOLDSTEIN :::2:~-.- ~-.C'
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Residence PO BOX 1039 )>c -.
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CARLISLE, PA 17013-6039 ~ /Jay ~
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, R1II'J)3~
on the day following such date, operate as a certificate of release as defined
in .IRC 6325(a). ,
Tax Period Date of Last Da.r. for Unpaid Balanc.!! '
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment" i
(a) (b) (c) (d) (e) (f)
1040 l2/3l/1997 181-54-0566 04/24/2000 OS/24/2010 7608.2l
l040 l2/3l/1998 181-54-0566 03/05/2001 04/04/2011 240l.62
Place of Filing
Prothonotary Total $
Cumberland County 10009.83
Carlisle, PA 17013
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This notice was prepared and signed at
PITTSBURGH, PA
. on this.
the
l5th day of May
2001
Signature r.) Title
for P SLANE ():;1:;br,:,t..,. ACS (800) 829-7650 23-01-0000
(HOTE: Certificate of officer authorized-by-niW'to 'tal<8 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. 10-00)
Part t - Kept By Recording Office CAT. NO 60025X