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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
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20041 Notice of Federal Tax Lien
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Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 594529909
As provided by section 6321, 6322, and 6323 of the Internal Revenue 4 X52
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made .2 3 3 0 1 I
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.
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Name of Taxpayer ROBERT E PEIFFER III
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Residence 141 MEADOWBROOK CT M
NEW CUMBERLND, PA 17070-2511 - -?
IMPORTANT RELEASE INFORMATION: For each assessment listed below, v {jr i
unless notice of the lien is refiled by the date given in column (e), this notice shall, I
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on the day following such date, operate as a certificate of release as defined
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in IRC 6325(a). x
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2000 XXX-XX-5540 12/16/2002 01/15/2013 1338.25
1040 12/31/2001 XXX-XX-5540 07/11/2005 08/10/2015 2145.12
1040 12/31/2004 XXX-XX-5540 05/30/2005 06/29/2015 280.57
1040 12/31/2006 XXX-XX-5540 03/30/2009 04/29/2019 1745.45
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 5509.39
This notice was prepared and signed at
the 29th day of October
DETROIT, MI
2009
, on this,
Signature A ACS 11-00-0000
for DEBRA K. HURST (800) 829-7650
(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)
Part 1 - Kept By Recording Office CAT. 668( (Rev. 2-2004)
CAT. NO 60025X