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Home My WebLink About01-03400 499 . Department of the Treasury - Internal Revenue Service form 168 (y)(c) Notice of Federal Tax Lien (Re>'. October 2000) Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS/SELF EMPLOYED AREA #3 #O/-3!jtJO ~ Lien Unit Phone: (800) 829-3903 230174632 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 2 C> ~ property belonging to this taxpayer for the, amount of these taxes, and - 'e. '-\ additional penalties, interest, and costs that may accrue. ~ :};1 :!l ;, l"-" ~gJ ;ac:: o~ Name of Taxpayer GERALD & DEBORAH BUSH , -~ ~{~ ,s:- rO :::;:1'"'"('4 ~ -0 -'-:Q :$ ~o ~S -fTl Residence 4 HUNTER LN - g ,.~ ., ~ CAMP HILL, PA 17011-2401 I"" .0 IMPORTANT RELEASE INFORMATION: For each assessment listed below, CK* d&- 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 Rtl,~q05 in IRC 6325(a). " Tax Period Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refillng of Assessment (a) (b) (c) (d) (e) (f) 1040 12/31/1994 073-46-0483 04/27/1997 OS/27/2007 734.19 1040 12/31/1997 073-46-0483 12/27/1999 01/26/2010 1289.28 1040 12/31/1998 073-46-0483 08/28/2000 09/27/2010 2102.38 ~ Place of Filing, Prothonotary Total $ Cumberland County 4125.85 Carlisle, PA 17013 This notice was prepared and signed at PITTSBURGH, PA , on this, 02nd day of May 2001 the Signature /:J.-tr::.L a LJ.:.4r...... ~~~ for L G D~~~ (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) Part 1 _ Kept By Recording Office Form 668(Y)(c) IRev. 10-00) CAT, NO 60025X 23-01-0008 - ''1'-1[ ~"Y1i/lld;, l""""""="""jIJ1,C "_"". " , ' '_~--'F'''"'''''''' ~~ I 1008 Department of the Treasury - Internal Revenue Service Form 668 (Z) Certificate of Release of Federal Tax Lien ./ ~'~ev. 10~2000) Area: Serial Number For Use bY Recording Office S~L BUSINESS/SELF EMFLOYED AREA #3 fJct, fJ~ 'duo Lien Unit Phone: (412) 395-5265 230174632 I certify that the following-named taxpayer, under the requirements of section 6325 (a) Ck- 1051-, 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 & J 5'/,/4t- additions has been released. The proper officer in the office where the notice of internal revenue tax lien was filed on June 04 C') ...., 2001 <= 0 , is authorized to note the books to show the release of this lien for c:: <= -n K .s:- these taxes and additions. vt."u % -l ~rn ",. i~ Name of Taxpayer :D -< ZC ro GERALD & DEBORAH BUSH CD..,.."'" -<2," en Sj, r-: '--1 0<'-- ",. :J:=H , ~o % ~Q 0 - Residence 4 HUNTER LN ::t>c: - Q,rn CAMP HILL, PA 17011-2401 Z; .. 0;4 , =< en :5 <:::> -< COURT RECORDING INFORMATION: Liber Page UCC No. Serial No. n/a n/a n/a 01-3400 FTL Tax Period Date of Last Dal.; for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Reflmg of Assessment (a) (b) (c) (d) (e) , (f) 1040 12/31/1994 073-46-0483 04/27/1997 OS/27/2007 734.19 1040 12/31/1997 073-46-0483 12/27/1999 01/26/2010 1289.28 1040 12/31/1998 073-46-0483 08/28/2000 09/27/2010 2102.38 ******** 'k*********** ************* **********i ************ **************** Place of Filing Prothonotary Cumberland County Total $ 4125.85 Carlisle, PA 17013 This notice was prepared and signed at Philadelphia, PA , on this, 19th day of May 2004 the ur~ f{. ~ 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. Ru!' 71~466, 1971 - 2 C.B. 409) Part 1 _ RECORDING OFFICE Form 668 (Z) (Rev, 10-2000) CAT, NO 600261 ~iWlflli~,ti1l.~". _~. ,_,,", "~r. ," , ~ => -11''1'''~~=' ~~"