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Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
(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) 913-6050
860176112
/2
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
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Name of Taxpayer JACK K HENCH r? ?
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Residence 5450 WESTBURY DR r r
ENOLA, PA 17025-3315
IMPORTANT RELEASE INFORMATION: For 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,
on the day following such date, operate as a certificate of release as defined ?
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in IRC 6325(a). 7
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
5329 12/31/2007 XXX-XX-5184 05/02/2011 06/01/2021 1812.18
5329 12/31/2008 XXX-XX-5184 05/02/2011 06/01/2021 1373.60
5329 12/31/2009 XXX-XX-5184 05/02/2011 06/01/2021 1006.19
6672 12/31/2007 XXX-XX-5184 03/21/2011 04/20/2021 11487.03
6672 03/31/2008 XXX-XX-5184 03/21/2011 04/20/2021 14324.08
6672 06/30/2008 XXX-XX-5184 03/21/2011 04/20/2021 12829.39
6672 09/30/2008 XXX-XX-5184 03/21/2011 04/20/2021 14175.60
6672 12/31/2008 XXX-XX-5184 03/21/2011 04/20/2021 12244.26
6672 03/31/2009 XXX-XX-5184 03/21/2011 04/20/2021 13160.72
6672 06/30/2009 XXX-XX-5184 03/21/2011 04/20/2021 4206.76
6672 09/30/2009 XXX-XX-5184 03/21/2011 04/20/2021 8803.28
6672 12/31/2009 XXX-XX-5184 03/21/2011 04/20/2021 7955.24
6672 03/31/2010 XXX-XX-5184 03/21/2011 04/20/2021 10360.47
6672 06/30/2010 XXX-XX-5184 03/21/2011 04/20/2021 9195.39
6672 09/30/2010 XXX-XX-5184 03/21/2011 04/20/2021 9373.53
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 132307.72
This notice was prepared and signed at
the 09th day of April
DETROIT, MI
2012
, on this,
Signature Title
REVENUE OFFICER 22-06-1408
for MIGNA RODRIGUEZ (717) 777-9622
(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 666(Y)(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025X