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Department of the Treasury - Internal Revenue Service
Form 668 ( Notice of Federal Tax Lien
(Rev. February 2 2004) 0041 nG- o q' y gro L F"TL
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 563862409
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 following-named 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
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer NGANDU T LUKUSA
Residence 5305 OXFORD DRIVE APARTMENT 130
MECHANICSBURG, PA 17055
For Optional Use by Recording Office
Pet. 00
6 309
)-.2 S/00
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 6325(a).
Tax Period Date o Last Day for
Kind of Tax Ending Identifying Number Assessmf ent Refilling
1040 12/31/2008 XXX-XX-0389 106/08/20091 07/08/2019
Place of Filing
3721.94
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 3721.94
This notice was prepared and signed at
the 09th day of July
DETROIT, MI
2009
, on this,
Signature H Title
REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
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(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rut. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X