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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004)
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
616420210 ,J
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Lien Unit Phone: (800) 913-6050 .
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 e / /gs,,y
a demand for payment of this liability, but it remains unpaid. Therefore, I
there is a lien in favor of the United States on all property and rights to ;;?? 3 L? q
property belonging to this taxpayer for the amount of these taxes, and IC I
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JOHN D BUCKWALTER
INTERIOR DESIGN WORKROOM
Residence 30 N 5TH ST
LEMOYNE, PA 17043-1610
ELEASE INFORMATION: For each assessment listed below,
he lien is refiled by the date given in column (e), this notice shall,
=
wing such date, operate as a certificate of release as defined
C6
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
941 09/30/2009 23-2218095 12/28/2009 01/2 7/2020 21846.02
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 21846.02
This notice was prepared and signed at
the 14th day of January
DETROIT, MI
2010
, on this,
Signature A Title
REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(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