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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice Of Federal Tax Lien ~7
(Rev. February 2004) 71,{y• d 9 " / ~ F TL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
513878909 {~,~, /J,~j~ ~/$, !I~
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Lien Unit Phone: (800) 913-6050 ~
As provided by section 6321, 6322, and 6323 of the Internal Revenue ~h. ~ ~~--3
Code, we are giving a notice that taxes (including interest and penalties) ~ ~ ? 0 7 z y
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but h remah>IS 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 c ~ ~`~n
addkional penalties, interest, and costs that may accrue. a Corporation U
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Name of Taxpayer CARING HANDS CHIROPRACTIC WELLNESS -~ m ro
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Residence 6 KACEY COURT -
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MECHANICSBURG, PA 17055-0000 ~- ::'
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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 (e), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 63251a1.
Tax Period Date of Last D for
fl
R Unpaid Balance
of Assessme~rt
Kind of Tax Ending Identifying Number Assessment g
e
a (b (c d (e? (
941 06/30/2008 71-0950354 09/29/2008 10/29/2018 3020.10
941 09/30/2008 71-0950354 12/15/2008 01/14/2019 1339.24
944 12/31/2007 71-0.950354 10/13/2008 11/12/2018 12947.51
Place of Filing
.Prothonotary
.Cumberland County
Carlisle, PA 17013
Total $ 17306.85
This notice was prepared and signed at DETROIT, MI
the 0 3rd day of February 2 0 0 9
on this,
Signature A Title
REVENUE OFFICER 22-06-1450
for JEFFREY WHITE (717) 777-9623 x1300
v:
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of reuerai i ax uen
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(ln(t) (Rev. 2-2004)
Part t -Kept fly Recording Office CAT. NO 60025x