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Form 668 (Y)(c)
(Rev. February 2004)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien ID
_ nr.,R FTL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 649830010 *19.pp PO PLFF
As provided by section 6321, 6322, and 6323 of the Internal Revenue CO I of 4S
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made ?? .141830
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 o
additional penalties, interest, and costs that may accrue. v
Name of Taxpayer JOHN D BUCKWALTER ' .1u.
INTERIOR DESIGN WORKROOM
Residence 30 N 5TH ST t-. ?I
LEMOYNE, PA 17043-1610
-a
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
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (f)
941 12/31/2009 23-2218095 04/05/2010 05/05/2020 19287.68
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 19287.68
This notice was prepared and signed at
the 28th day of April
DETROIT, MI
2010
, on this,
Signature Title
REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
%91W I c: UerUnCare or orncer autnonzeo oy law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rui. 71-466, 1971 - 2 C.B. 409)
Part I - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X