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Department of the Treasury - Internal Revenue Service
Form 668 (Y Notice of Federal Tax Lien
(Rev. February 20004) 41
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 847502212
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,
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. r
Name of Taxpayer JOHN D BUCKWALTER ? m` -
INTERIOR DESIGN WORKROOM
Residence
30 N 5TH ST ` = -
c
LEMOYNE, PA 17043-1610
NT RELEASE INFORMATION: For each assessment listed below, R
e of the lien is refiled by the date given in column (e), this notice shall,
F
a?j,? .
T
following such date, operate as a certificate of release as defined
RC
5(a).
Tax Period Date of Last Da y 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 09/30/2011 23-2218095 01/02/2012 02/01/2022 18316.69
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 18928.03
This notice was prepared and signed at
the 03rd day of February
DETROIT, MI
2012
, on this,
iture Title
REVENUE OFFICER 22-06-1408
TGNA RODRIGUEZ (717) 777-9622
'E: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
1. 71-466, 1971 - 2 C.B. 409)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 60025X