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Department of the Treasury - Internal Revenue Service F71 -
(Rev. 668 (Y)(c) Notice of Federal Tax Lien
IRev. February 2004) 10 -01 Iai 4iV-+-48r1K
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2 _
Lien Unit Phone: (800) 829-3903 636148510 00 PO P
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PF
As provided by section 6321, 6322, and 6323 of the Internal Revenue I? .
1
1 ,
Code, we are giving a notice that taxes (including interest and penalties) CIL 13411
have been assessed against the following-named taxpayer. We have made 51145'
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 n o
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JON R SPATZ rnCr?
r' Fn
Residence PO BOX 200
CAMP HILL, PA 17001-0200
C- c.o
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, Cn
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 Refiling of Assessment
(a) (b) (c) (d) (e) (1)
1040 12/31/2005 XXX-XX-2138 02/13/2006 03/14/2016 4262.20
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 4262.20
This notice was prepared and signed at
the 19th day of March
DETROIT, MI
2010
, on this,
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 i ax 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