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Department of the Treasury - Internal Revenue Service
Form 668 (2)04) Notice of Federal Tax Lien
(Rev. February 2004) ? • n 9 _ 07 e. -7,6 Fr L
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
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Lien Unit Phone: (800) 829-3903 538427909 •
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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)
have been assessed against the folbwinrnamed taxpayer. We have made
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 N
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property belonging to this taxpayer for the amount of time taxes, and
additional penakies, interest, and costs that may accrue. -
,
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Name of Taxpayer THOMAS C & KATHLEEN M PETTY JR Q
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Residence 909 NEWVILLE RD
CARLISLE, PA 17013-1736
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (a), this notice shall,
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following such date, operate as a certificate of release as defined
IRC
5(a).
Tax Period Date of Last for
? U npaid Balance
Kind of Tax Ending Identifying Number Assessment ReA
g of Assessment
a b c) d (e) M
1040 12/31/2005 XXX-XX-4482 12/15/2008 01/14/2019 3396.68
1040 12/31/2006 XXX-XX-4482 05/21/2007 06/20/2017 2983.10
1040 12/31/2007 XXX-XX-4482 05/26/2008 06/25/2018 2685.74
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 9065.52
This notice was prepared and signed at
DETROIT, MI
the 21st day of April 2009
, on this,
Signature A Title
ACS 22-00-0008
for MICHAEL W. COX (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) Form 668(Y)(c) (Rev. 2-2004)
Pure 1 - Kept By Rwwdlns Offke CAT. NO 60025X