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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. October 2000)
A Serial Number For Optional Use by Recording Office
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WAGE & INVESTMENT AREA #2
230177159 rf1- ~/
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Lien Unit Phone: (Boo) 829-7650 j
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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 c~ -.
property belonging to this taxpayer for the amount of these taxes, and ~
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additional penalties, interest, and costs that may accrue. _
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Name of Taxpayer GERALD W BURKE SR = ~ ""'
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Residence 235 E ORANGE ST -`
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SHIPPENSBURG, PA 17257-2005 _=4
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, ,~
unless notice of the lien is refiled by the date given in column lel, this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 63251a1~ ~ I
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (fl
1040 12/31/1995 192-34-6870 12/14/1998 01/13/2009 2598.46
1040 12/31/1996 192-34-6870 12/07/1998 01/06/2009 2401.11
1040 12/31/1998 192-34-6870 06/07/1999 07/07/2009 1055.40
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total I$
6054.97
This notice was prepared and signed at
PITTSBURGH, PA
the 04th day of July 2001
Signature
`_, .t~ t ~ ACS
on this,
for P S LANE 23-01-0000
(800) 829-7650
(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) (Rev. 10-00)
Part 1 -Kept By Recording Office CAT. NO 60025X
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