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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 945511413 13 - - - 37 f L
As provided by section 6321, 6322, and 6323 of the Internal Revenue DD //
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following -named taxpayer. We have made c o
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 z m c' --
property belonging to this taxpayer for the amount of these taxes, and . r I
additional penalties, interest, and costs that may accrue. -C> --- CD
Name of Taxpayer LEOLA RESTAURANT CORP, a Corporation CD '0 —
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w( c i >
Residence 3127 S 4TH AVE ---- :7j
WHITEHALL, PA 18052
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, 1�,� - �, %<
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)
6721 12/31/2008 01- 0828605 03/28/2011 04/27/2021 2910.00
941 03/31/2007 01- 0828605 10/08/2007 11/07/2017 14540.95
Place of Filing
Prothonotary
Cumberland County Total $ 17450.95
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 19th day of June 2013
Signature Title
REVENUE OFFICER 22 -08 -2815
for M. ACEVEDO (610) 861 -5686
(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 668(Y)(c) (Rev. 2 -2004)
Part 1 - Kept By Recording Office CAT. NO 60025X