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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(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 935888813
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. c "
Name of Taxpayer WEST SHORE BEVERAGE DISTRIBUTOR INC rnCo
a Corporations .,a
Residence
50 E SHADY LN r -
ENOLA, PA 17025 -2325 �a `*{
O _
[ 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,
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 Refiling of Assessment
(a) (b) (c) (d) (e) (f)
941 06/30/2010 23- 2386313 10/22/2012 11/21/2022 17306.49
941 09/30/2010 23- 2386313 10/22/2012 11/21/2022 16496.05
941 12/31/2010 23- 2386313 10/22/2012 11/21/2022 18814.30
941 03/31/2011 23- 2386313 10/22/2012 11/21/2022 16122.99
941 06/30/2011 23- 2386313 10/22/2012 11/21/2022 15145.10
941 09/30/2011 23- 2386313 10/22/2012 11/21/2022 16814.58
941 03/31/2012 23- 2386313 10/22/2012 11/21/2022 13423.26
Place of Filing
Prothonotary
Cumberland County Total $ 114122.77
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 25th day of April 2013
Signature Title
\C- 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)
AT
Part 1 - Kept By Recording Office Form 668( C (Rev. 2
CAT. NO 60025X X