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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 575684009
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
S
Residence 11 GARDEN DR
CARLISLE, PA 17013-1211
For Optional Use by Recording Office
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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 6325(a).
Tax Period Date of Last Day for
Kind of Tax Ending Identifying Number Assessment Refiling
1040 112/31/2005
1040 12/31/2006
1040 12/31/2007
XXX-XX-8126 105/22/20061 06/21/2016
XXX-XX-8126 05/21/2007 06/20/2017
XXX-XX-8126 05/26/2008 06/25/2018
Unpaid Balance
of Assessment
5119.76
2684.46
6822.20
x..
CY
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 14626.42
This notice was prepared and signed at DETROIT, MI
, on this,
the 25th day of August 2009
Signature A 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 666(Y)(c) (Rev. 2-2004)
Part I - Kept By Recording Office CAT. NO 60025X
4804 Department of the Treasury - Internal Revenue Service
Form 668 (Z)
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Area: Serial Number For Use by Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 913-6050 575684009
I certify that the following-named taxpayer, under the requirements of section 6325(a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on September 02 -- '
2009 , is authorized to note the books to show the release of this lien for -,..m r
-
these taxes and additions. �� r=,.) -
Name of Taxpayer ,J '- a
GARY R JONES . c_
Y
Residence 11 GARDEN DR , --
CARLISLE, PA 17013-1211
COURT RECORDING INFORMATION: �1^, `,,, �-
Liber Page UCC No. Serial No. -fr n/a n/a n/a 09-6018-FTL Ot ...2c7.2s1-/
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-8126 05/22/2006 06/21/2016 5119 . 76
1040 12/31/2006 XXX-XX-8126 05/21/2007 06/20/2017 2684 .46
1040 12/31/2007 XXX-XX-8126 05/26/2008 06/25/2018 6822 .20
**************************************************************************
Place of Filing
Prothonotary
Cumberland County Total $ 14626 .42
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 09th day of October 2013 .
Signature Title
\ Cres.c... Operations Manager,
Centralized Case Processing-Lien Unit
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000)
Part 1 -RECORDING OFFICE CAT. NO 600261