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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 #15
Lien Unit Phone: (800) 913 -6050 929501313
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 r*i��
additional penalties, interest, and costs that may accrue. -
Name of Taxpayer CARL E HOFFMAN Zr I 7C C)
Residence 145 N WEST ST
CARLISLE, PA 17013 -2337 ;: Cn
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 /,.S j'
on the day following such date, operate as a certificate of release as defined
in IRC 6325(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)
1040 12/31/2007 XXX -XX -6221 10/24/2011 11/23/2021 3811.71
1040 12/31/2008 XXX -XX -6221 10/24/2011 11/23/2021 3876.47
1040 12/31/2009 XXX -XX -6221 10/24/2011 11/23/2021 2351.46
Place of Filing
Prothonotary
Cumberland County Total $ 10039.64
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 22nd day of March 2013
Signature /" ;'�� Title
REVENUE OFFICER 35 -79 -6834
for LUZ M RODRIGUEZ FLORES (267) 941 -5087
(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 668(Y)(c) (Rev. 2 - 2004)
CAT. NO 60025X