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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004}
Notice of Federal Tax Lien
A Serial Number For Optional Use by Recording Office
rea:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: {800) 513-6050
725978610 /
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As provided by section 6321, 6322, and 6323 of the Internal Revenue
Cade, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand far payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the united States on alt property and rights to ~-, ~
property belonging to this taxpayer for the amount of these taxes, and 'nom c~ ~
additional penalties, interest, and casts that may accrue.
Name. of Taxpayer ROBIN PRIFER . ~p
CREATIVE LOOKS STYLING SALON ~~ -
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Residence 3 8 0 8 GETTYSBURG RD ~ ~ ~ c~
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CAMP HILL, PA 17011-6808 ~ ~ ~
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IMPORTANT RELEASE INFORMATION: Far each assessment listed below,
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unless notice of the lien is refiled by the date given in column {e), this notice shall, /
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on the day following such date, operate as a certificate of release as defined
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IRC 6325
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Tax Period Date of Last Dayy far Einpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (~
941 06/30/2010 25-1777232 11/08/2010 12/08/2020 4597.56
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total I $
4597.56
This notice was prepared and signed at ~ DETROIT, MI
the 29th day of November 2010
on this,
Signature `=^^~~ Title
~ZC` REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(NOTE: Certificate of officer authorized by law to take acknawladgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul, 71-4Fi8, 1971 - 2 C.B. 4091 Form 66$(Y){c) {Rev. 2-2004?
Part t -Kept By RecarcCieg Office CAT. NO 60025X