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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev
Februar
2004)
Notice of Federal Tax Lien NO.
3 g-S-5
?d 4
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.
y
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 663623310
As provided by section 6321, 6322, and 6323 of the Internal Revenue n?
Code, we are giving a notice that taxes (including interest and penalties) C -n
have been assessed against the following-named taxpayer. We have made ?
a demand for payment of this Iiabillty, but it remains unpaid. Therefore, :.
FT;
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
additional penalties, interest, and costs that may accrue.
Name of Taxpayer DOUGHERTY HOME IMPROVEMENTS INC C
a Corporation i'
ti.
Residence 4345 A CARLISLE PIKE
CAMP HILL, PA 17011-4128
as
>c1q
,
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 R, H'y3 5 s?
in IRC 6325(a).
Tax Period Date of Last D for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refing of Assessment
(a) (b (c d) (e) (f)
940 12/31/2008 81-0636767 05/17/2010 06/16/2020 230.48
940 12/31/2009 81-0636767 05/17/2010 06/16/2020 215.58
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 446.06
This notice was prepared and signed at
the 04th day of June
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)
Part 1 - Kept By Recordint Office CAT. 668( (Rev. 2-20041
CAT. NO 60025X