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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Nut~Ce of Federal Tax Lien In ~~~~ 1~-,
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903
653005510
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As provided by section 6321, 6322, and 6323 of the Internal Revenue CK-'I l Daog
Code, we are giving a notice that taxes (including interest and penalties) E~ a 4 ao91
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore :
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there is a lien in favor of the United States on all property and rights to ,
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property belonging to this taxpayer for the amount of these taxes, and +
additional penalties, interest, and costs that may accrue. ~-- ~ ~- -•= r-
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Name of Taxpayer JOHN S & DOLORES A KAUFFMAN `
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Residence 315 ELGIN CIR y, ~ = w `~~~
MECHANICSBURG, PA 17055-6152 .:~ ~~
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 Dayy for
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (fl
1040 12/31/2007 XXX-XX-3618 06/02/2008 07/02/2018 12879.99
1040 12/31/2008 XXX-XX-3618 06/22/2009 07/22/2019 5039.17
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 17919.16
This notice was prepared and signed at
the 06th day of May
DETROIT, MI
2010
on this,
Signature ~ y ~/~ 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 t -Kept By Recording Office CAT. NO 60025X
3621 Department of the Treasury -Internal Revenue Service
Form 668 (Z) Certificate of Release of Federal Tax Lien
(Rev. 10-20001
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 653005510
I certify that the following-named taxpayer, under the requirements of section 6325 la-
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
Use
internal revenue tax lien was filed on May 14 C"> Q
2 010 is authorized to note the books to show the release of this lien for ~- o '~
these taxes and additions. c°,~ ~-, ~_: -~-r±
Name of Taxpayer -= ! ~ -r',
JOHN S & DOLORES A KAUFFMAN ~" ``:~; ,= ,
Residence 315 ELGIN CIR ~~ rya F;!
MECHANICSBURG, PA 17055-6152 ~ ~? .
COURT RECORDING INFORMATION : ~, ~~ ~~ ~f~ , °~ti
_
Liber Page UCC No. Serial No. " "
°~""`
n/a n/a n/a 10-3207FTL a~'$~3
Tax Period Date of Last Dar~rr for lJnpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
1040 12/31/2007 XXX-XX-3618 06/02/2008 07/02/2018 12879.99
1040 12/31/2008 XXX-XX-3618 06/22/2009 07/22/2019 5039.17
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 17 919.16
This notice was prepared and signed at
the 30th day of June
Signature
DETROIT, MI
2010
on this,
Title Director, Campus Compliance
Operations
(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-20001
Part 1 -RECORDING OFFICE CAT. NO 600261