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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 948457613
As provided by section 6321, 6322, and 6323 of the Internal Revenue 13
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
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additional penalties, interest, and costs that may accrue. r„
Name of Taxpayer LEAHYS AUTO COLLISION REPAIR LLC
Dr --,
Residence - r
1051 COLUMBUS AVE �! C:)
LEMOYNE, PA 17043
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 r
on the day following such date, operate as a certificate of release as defined fact
in IRC 6325(a).
Tax Period Date of Last Da for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
941 03/31/2011 26- 4167728 06/20/2011 07/20/2021 3513.76
941 06/30/2011 26- 4167728 10/03/2011 11/02/2021 6317.55
941 09/30/2011 26- 4167728 01/09/2012 02/08/2022 5613.27
941 12/31/2011 26- 4167728 04/09/2012 05/09/2022 1485.66
Place of Filing
Prothonotary
Cumberland County Total $ 16930.24
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 08th day of July 2013
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)
Form 668( CAT (Rev. 025X )
Part 1 - Kept By Recording Office
CAT. NO 60025X