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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) ')1. 7 36 CJ X F''L
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 364155307
As provided by section 6321, 6322, and 6323 of the Internal Revenue ?Sg
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made 9 3 043
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 rv
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additional penalties, interest, and costs that may accrue. -
Name of Taxpayer STACY J BLOSSER
nit--
7\3
Residence 730 HILLSIDE DR
CARLISLE, PA 17013-3610
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
F
following such date, operate as a certificate of release as defined
5(a).
IRC
Tax Period Date of Last Day f or Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-3505 05/29/2006 06/28/2016 8006.87
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total J$ 8006.87
This notice was prepared and signed at
DETROIT, MI
the 10th day of May 2007
, on this,
Signature )K? A )/-ham Title
ACS 11-00-0000
for DEBRA K. HURST (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)
Part 1 - Kept By Recording Office CAT. 668( (Rev. 2-20041
CAT. NO 60025X
2447 Department of the Treasury - Internal Revenue Service
Form 668 (Z) C rtificate of Release of Federal Tax Lien
(Rev. 10-2000)
Area: Serial Number For Use by Recordin g Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 913-6050
364155307
$$,00 Pb
PLYF
?L I3asg
I certify that the following-named taxpa er, under the requirements of section 6325 (a)
of the Internal Revenue Code has sati fied the taxes listed below and all statutory ?,?` a 3ga9 y
additions. Therefore, the lien provide by Code section 6321 for these taxes and
additions has been released. The pro er officer in the office where the notice of
internal revenue tax lien was filed on May 22 n,a
C'1 Q,
2007
is authorized to note t e books to show the release of this lien for
°
these taxes and additions. a
Name of Taxpayer iV
STACY J BLOSSER w
Residence730 HILLSIDE DR :>> ••
CARLISLE, PA 1701 -3610
COURT REC RDING INFORMATION:
Liber Page UCC No. Se ial No.
n/a n/a n/a 20 7-3098
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Iden ifying Number Assessment Refiling of Assessment
(a) b) c) d) e f
1040 12/31/2005 XX -XX-3505 05/29/2006 06/28/2016 8006.87
Place of Filing
Prothonot ry
Cumberlan County
Carlisle, PA 17013
Total J$ 8006.87
This notice was prepared and signed at
the
10th day of March
2010
DETROIT, MI
, on this,
Signature
I I Title Operations Campus Compliance
?? R .
(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. Rul. 71-466, 1971 - 2IC.6. 409) Form 668 (Z) (Rev. 10-2000)
Part 1 - RECORDING OFFICE CAT NO 600261