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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 745014611 r ?,??? r(?
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As provided by section 6321, 6322, and 6323 of the Internal Revenue (
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Code, we are giving a notice that taxes (including interest and penalties) MCC c..
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have been assessed against the following-named taxpayer. We have made =? ?
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a demand for payment of this liability, but it remains unpaid. Therefore, w
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there is a lien in favor of the United States on all property and rights to r--Z ---sc?
property belonging to this taxpayer for the amount of these taxes, and y° 3 (D-n
additional penalties, Interest, and costs that may accrue. _c 5cc7
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Name of Taxpayer WAYNE E BRINKERHOFF
Residence 139 BRIDGE ST
NEW CUMBERLND, PA 17070-2124
PORTANT RELEASE INFORMATION: For each assessment listed below,
ess notice of the lien is refiled by the date given in column (e), this notice shall,
the day following such date, operate as a certificate of release as defined
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IRC 6325(a).
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refil ing of Assessment
(a) (b) (c) (d) (e (f)
1040 12/31/2008 XXX-XX-1456 06/01/2009 07/01/2019 3534.61
1040 12/31/2009 XXX-XX-1456 05/24/2010 06/23/2020 4409.34
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 7943.95
This notice was prepared and signed at DETROIT, MI
the 2 0 th day of January 2011
, on this,
Signature Title
ACS 22-00-0001
for FRED BANKS (800) 829-3903
(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) Form 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X
Form 668 (Z) 11883 Department of the Treasury - Internal Revenue Service
(Rev. 10-2000) Certificate of Release of Federal Tax Lien
Hrea: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 745014611
1 certity that the following-named taxpayer, under the requirements of section 6325 (a)
of the Internal Revenue Code has satisfied the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
additions has been released. The proper officer in the office where the notice of
internal revenue tax lien was filed on January 31
2 011_ , is authorized to note the books to show the release of this lien for
these taxes and additions.
Name of Taxpayer
WAYNE E BRINKERHOFF
Residence 13 9 BRIDGE ST
NEW CUMBERLND, PA 17070-2124
COURT RECORDING INFORMATION:
Liber Page UCC No. Serial No.
n/a n/a n/a 11-1032
Tax Period Date of
Kind of Tax Ending identifying Number Assessment
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2 ? 2>m. rT1 _ ,
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f
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a giy
Last Dayy for Unpaid Balance
RefiliI of Assessment
1.040 12/31/2008 XXX-XX-1456 06/01/2009 07/0172019 3534
61
1040 12/31/2009 XXX-XX-1456 05/24/2010 06/23/2020 .
4409
34
.
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Use by Recordinq Office
Total $ 7943.95
This notice was prepared and signed at DETROIT, MI
, on this,
the 27th day of April 2011
Signature e , e Title Director, Campus Compliance
Operations tn%y1 C: Uertiticate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of
Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409)
Part 1 - RECORDING OFFICE Form 668 (Z) (Rev. 10-2000)
CAT. NO 600261