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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c)
Notice Of Federal Tax Lien
(Rev. February 2004) . b7- 4s8o ~TL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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Lien Unit Phone: (800) 913-6050 379751307 l
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As provided by section 6321, 6322, and 6323 of the Internal Revenue ~ lL Y~ ~
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made /~ ~ yG
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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
additional penalties, interest, and costs that may accrue. ~ r.~,•
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Name of Taxpayer DAVID J THOMAS C ~ ~
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Residence 110 WALNUT STREET ~ ,~;: tv~j~
LEMOYNE , PA 17 0 4 3 `-~- " _~ -r;
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, "'
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unless notice of the lien is refiled by the date given in column (e), this notice shall, :.,~ o ~
on the day following such date, operate as a certificate of release as defined ~-'~ "~
in IRC 6325(a).
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
940 12/31/2005 02-0729680 04/24/2006 05/24/2016 1061.98
941 09/30/2005 02-0729680 02/13/2006 03/14/2016 26576.22
941 12/31/2005 02-0729680 04/10/2006 05/10/2016 668.48
941 03/31/2006 02-0729680 03/05/2007 04/04/2017 42624.96
941 06/30/2006 02-0729680 03/05/2007 04/04/2017 9897.92
941 09/30/2006 02-0729680 04/02/2007 05/02/2017 4035.87
941 12/31/2006 02-0729680 05/14/2007 06/13/2017 27694.66
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 112560.09
This notice was prepared and signed at
DETROIT, MI
the 23rd day of July 2007
on this,
Signature ~ A ~Yy~~ Title
REVENUE OFFICER 22-06-1450
for JEFFREY WHITE (717) 777-9623 x1300
(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. 4091
Part 1 -Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X