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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice Of Federal Tax Lien -~,r
IRev. February 20041 /1~. Q ~- 3 9 9~ ~rL
Area: Serial Number For Optional Use by Recording Oftice
SMALL BUSINESS/SELF EMPLOYED AREA #2
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453448508 ~ ~ ~~9.UZ~
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Lien Unit Phone: (800) 913-605 y
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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) Ck.
have been assessed agah~st the folbwing-named taxpaysr. We have made ~ a ~ ~ ~ 7 p'
a demand for payment of this IiabiNty, but it remains unpaid. Therefore,
there is a lien in favor of the !!Wiled States on aq property and rights to
property belonging to thLs taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. - ^,,
Name of Taxpayer JADA ASSOCIATES INC a Corporation
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Residence 600 N FRONT- ST
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WORMLEYSBURG, PA 17043-1022
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IMPORTANT RELEASE INFORMATIOI~I: For each assessment listed below, .; ~
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 Cd
in IRC 6325{a).
Tax Period Date of Last ppa~yy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment ReflOng of Assessment
(a) (b (c d (e ~
940 12/31/2007 20-0482643. 05/05/2008 06/04/2018 357.06
941 09/30/2007 20-0482643 12/31/200.7 01/30/2018 12040.45
941 12/31/2007 20-0482643 03/31/2008 04/30/2018 9765.84
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 22163.35
This notice was prepared and signed at DETROIT, MI
the 26th day of June 2008
on this,
Signature ~ A ~Yti~~ Title
REVENUE OFFICER 22-06-1442
for DAVID M. SHROYER (717) 777-9625 x1320
(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 RecordinE Office Form 668(Y)(c) IRev. 2-2004)
CAT. NO 60025X