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Form 668 (Y)(c)
(Rev. October 2000)
Area: I Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 230173083
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 belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer SUSAN M EVERHART
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Residence
1709 ENGLISH DR
MECHANICSBURG, PA 17055-5646
For Optional Use by Recording Office
I]MPORTANI' RELE'A*SF' iNFORM'~IkTION: F°r each assessment listed bel°w'
unless notice of the lien is refiled by the date given in column (e), this notice shall,
in°n the day following such date, operate as a certificate of release as definediRc 6325(a).
Tax Period Date of Last Day for Unpaid Balance
KindofTax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
'1040 12/31/1995 165-56-7574 09/14/1998 10/14/2008 1545.62
1040 12/31/1996 165-56-7574 09/14/1998 10/14/2008 5538.11
1040 12/31/1999 165-56-7574 05/22/2000 06/21/2010 3309.14
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
10392.87
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the 28th day of March 2001
Signature ~'~ Title
: ~ ACS 23-01-0008
for L G DowD ~"'~ (800) 829-3903
(NO?E: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal 'Fax lien
Rev. Rul. 71-466, 1971 - 2 C.B, 409)
Part ! - KeDt By Recording Office Form 6&8(Y)(c) (Rev. 10-00)
CAT, NO $0025X