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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice Of Federal Tax Lien ~ ~~ p ~ ,~ ~ ~ ~...T~
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Ph
one: (800) 829-3903 428019108 ~~. ~~ a/~i.lrp
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) ~ ~ 3 3 °U
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore, ~ .16 ~ a ~ y
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. ~ ~ ~
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Name of Taxpayer KEVIN A WHITE f~par ~ ~~~
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Residence
PO BOX 13 6 3 r= ` r
,7=• .- --r~ r ,
MECHANICSBUR.G, PA 17055-1363 ~_1-.
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, t.~
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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
in IRC 6325(a).
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Daayy for
Reflling lJnpaid Balance
of Assessment
(a) b) (c) (d) (e) (~
1040 12/31/1999 XXX-XX-8461 07/23/2007 08/22/2017 7456.63
1040 12/31/2000 XXX-XX-8461 07/23/2007 08/22/2017 7514.73
1040 12/31/2001 XXX-XX-8461 07/23/2007 08/22/2017 9624.18
1040 12/31/2002 XXX-XX-8461 04/17/2006 05/17/2016 3864.73
1040 12/31/2003 XXX-XX-8461 02/26/2007 03/28/2017 3498.39
1040 12/31/2004 XXX-XX-8461 07/23/2007 08/22/2017 2732.11
Place of Filing
Prothonotary
Cumberland County Total $ 34690.77
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 07th day of March 2008
Signature A ~ Title
ACS 22-00-0008
for REGINA OWENS (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(ln(c) (Rev. 2-2004)
CAT. NO 60025X