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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 #2
Lien Unit Phone: (800) 913-6050 861265412
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) y 6
have been assessed against the following-named taxpayer. We have made c
a demand for payment of this liability, but it remains unpaid. Therefore,
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there is a lien in favor of the United States on all property and rights to v r
property belonging to this taxpayer for the amount of these taxes, and N
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additional penalties, interest, and costs that may accrue. 3?' w
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Name of Taxpayer DGA INC, a Corporation 1:7 3a
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Residence 121 N PITT ST C3 '
CARLISLE, PA 17013-2334
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refilled by the date given in column 1e1, this notice shall, ??. SZ) ?ll • ?! ,
on the day following such date, operate as a certificate of release as defined
IRC 6325(
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e)
941 09/30/2011 25-1580679 03/12/2012 04/11/2022 8639.76
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 8639.76
This notice was prepared and signed at
DETROIT, MI
, on this,
the 13th day of April
2012
Signature - - Title
REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(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)
Part 1 - Kept By Recording Office Form 66SM(c) (Rev. 2-2004)
CAT. NO 60025X