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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien o j_ 6-? a? FTZ.
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
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Lien Unit Phone: (800) 913-6050 572833609 .
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As provided by section 6321, 6322, and 6323 of the Internal Revenue C k 5q
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
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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 6108 CARLISLE PIKE RESTAURANT
COMPANY LLC
a Partnership --
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Residence 6108 CARLISLE PIKE its r-
MECHANICSBURG, PA 17050-5243 _
IMPORTANT RELEASE INFORMATION: For each assessment listed below, NO
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 of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
940 12/31/2008 02-0729680 04/06/2009 05/06/2019 1630.43
941 09/30/2008 02-0729680 07/13/2009 08/12/2019 28273.88
941 12/31/2008 02-0729680 03/16/2009 04/15/2019 28284.35
941 03/31/2009 02-0729680 06/22/2009 07/22/2019 20525.56
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 78714.22
This notice was prepared and signed at
the 13th day of August
Signature
DETROIT, MI
2009
, on this,
Title
REVENUE OFFICER 22-06-1442
for DAVID M. SHROYER 1 (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)
Recording Office Form 668(lt)(c) (Revd 2, 2004)
Part 1 - Kept By g C,0.T, %'0 ,, ..026X