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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA 42
Lien Unit Phone: (800) 913-6050 827369011
As provided by section 6321, 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, r-,
there is a lien in favor of the united States on all property and rights to r
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. am
Name of Taxpayer JOHN D BUCKWALTER
INTERIOR DESIGN WORKROOM r
Residence 30 N 5TH ST C:) C-)
LEMOYNE, PA 17043-1610
A
F
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall, ?? j -
on the day following such date, operate as a certificate of release as defined
i
IRC 6325
n
(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
940 12/31/2009 23-2218095 05/02/2011 06/01/2021 611.34
941 09/30/2010 23-2218095 12/06/2010 01/05/2021 460.55
941 12/31/2010 23-2218095 03/28/2011 04/27/2021 529.43
941 03/31/2011 23-2218095 07/04/2011 08/03/2021 15636.62
941 06/30/2011 23-2218095 09/26/2011 10/26/2021 14471.76
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 31709.70
This notice was prepared and signed at DETROIT, MI
the 08th day of November 2011
, on this,
Signature Title
Lr` REVENUE OFFICER 22-06-1441
for DENNIS P ZMUDZIN (717) 777-9624
(NOTE: Certificate c4 officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1 )71 - 2 C.B. 409)
Part I - Kept By Recording Office Form 6b8(Y)(c) {Rev. 2 2004!
CAT Nn annncv