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Department of the Treasury - Internal Revenue Service
Form 666 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED A':R.EA #2
Lien Unit Phone: (800) 913-6050 684855210
As provided by section 6321, 632 , and 6323 of the Internal Revenue
Code, we are giving a notice that es (including Interest and penalties)
have been assessed against the foil I -named taxpayer. We have made
a demand for payment of this liabili , but it remains unpaid. Therefore,
there is a lien in favor of the knit States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and c is that may accrue.
Name of Taxpayer KIMBERLY L MARTIN
HORSEFEATHERSI HAIR DESIGN
Residence 5230 S IMPSON FERRY RD
MECHINCSBURG,; PA 17050-3514
IMPORTANT RELEASE INFORMA ON: For each assessment listed below,
unless notice of the lien is refiled by the ate given in column (e), this notice shall,
on the day following such date, opera a as a certificate of release as defined
in IRC 6325(a).
10 -5??3 ?T t-
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Unpaid Balance
of Assessment
Tax Period ' Date of Last Day for
Kind of Tax Ending Identifying Number Assessment Refiling
(a) b) c (d) (e)
941 12/31/2009 23-2941949 03/15/2010 04/14/2020
Place of Filing
Prothonotary
Cumberland County
Carlisle, PAi,17013
304.32
Total $ 304.32
This notice was prepared and signed at
DETROIT, MI
, on this,
the 03rd day of August 1, 2010
Signature A 'I RIEVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(NOTE: Certificate of officer authorized by
Rev. Rul. 71-466, 1971 - 2 C.B. 409)
v to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X
118 8 3 Qepartment of the Treasury -Internal Revenue Service
Form 109 t 6(c) Withdrawal of Filed Notice of Federal Tax Lien
(Rev. 10-20001
Area: Serial Number For Optional Use by Recordin Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 684855210 fb^ ~~~? ~'~"'~
J
t certify that the following-named taxpayer has met one or more of the dements
of the Internal Revenue Code (IRC) section 6323(j). The Imernal Revenue Service
therefore withdraws the Notice of Federal Tax Uen for these taxes and additions. ~
The withdrawal of this notice of lien does not affect the statutory lien provided ~, ~
by [RC section 6321; it simply relinquishes any lien priorhy obtained by the Internal G
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~
Revenue Service when the notice was filed. The proper offidal, in the office where -'s'~
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the Notice of Federal Tax Lien was filed on Au us t 10 2 010 ~~ n ~
is authorized to update the records to show t t rawa o the no ce en --i
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:
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for these taxes and additions. ~ -"
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Name of Taxpayer -^~'~
~.®
KIMBERLY L MARTIN ..c ~ ~~
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HORSEFEATHERS HAIR DESIGN ~
~
~~
Residence 5230 SIMPSON FERRY RD ~
~~ ~- ~'
~
MECHINCSBURG, PA 17050-3514 ~ N
-~
COURT RECORDING INFORMATION :
l N ~~G4~titi~~~~ y~~,,~,/_
g' ~
"d' `~`~''
o .
Giber Page UCC No . Seria /
n/a n/a n/a 10-5243 -~~h'7~
Tax Period Date of Last Dayy for unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
lal lbJ (cJ ldJ lel /fJ
941 12/31/2009 23-2941949 03/15/2010 04/14-/2020 304.32
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 304.32
This notice was prepared and signed at
the 0 & th day of
October
Signature
on this,
Title Director, Campus Compliance
Operations
cC.t~
k
DETROIT, MI
2010
Cat. No. 24586T .Farm 10916(c) (Rev. 10-2000!
Part 1 -Recording Office