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Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
612887110 ?
(o - Age T
As provided by section 6321, 6322, and 6323 of the Internal Revenue
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ng a notice that taxes (including interest and penalties) 14• UD
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 iz a ate.
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JAMES R STOLTZ
Residence 143 A ST
CARLISLE, PA 17013-1903
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).
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Day for
Reflling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2006 XXX-XX-5706 04/27/2009 05/27/2019 ,260880.97
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 26080.97
This notice was prepared and signed at
the 05th day of January
DETROIT, MI
2010
, on this,
Signature y Yh4ZF/? 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)
Part 1 - Kept By Recording Office CAT. NO 60025X