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Form 668 (Y)(c)
(Rev. October 2000)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA ~3
Lien Unit Phone: (800) 829-3903 230170782
As provided by section 632l, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
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 belonldng to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer ROHA'z~E F PALMER
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optional Use by Recording Office
Residence 148 AMY DR
CARLISLE, PA 17013-8884
IMPORTANT RELEASE 'NFOR"ATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in co,umn (ak this notice shall,
on the da,/ 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 Retiring of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1996 125-42-2367 07/05/1999 08/04/2009 6276.48
1040 12/31/1998 125-42-2367 05/24/1999 06/23/2009 737.27
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
7013.75
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the 13th day of February 2001
Signature '-, : '.': ( Title
J ACS 23 -01-0008
for L G DOWD (800) 829-3903
(~lOl'E; 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. 10-00)
Part I - Kept By Recording Office
CAT. NO 60025X