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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 #2
Lien Unit Phone: (boo) 913 - 6050 954340413
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 a'`,;
property belonging to this taxpayer for the amount of these taxes, and y
additional penalties, interest, and costs that may accrue. _.
Name of Taxpayer ANN BARR = `
RLB SERVICES
Residence 6838 WERTZVILLE RD
ENOLA, PA 17025 -1032
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 ;2 S"Z� 10�{ • .
in IRC 6325(a). PY* a ysl,4
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)
941 03/31/2013 20- 4075486 07/08/2013 08/07/2023 1020.40
Place of Filing
Prothonotary
Cumberland County Total $ 1020.40
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 08th day of August 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(Y)(c) (Rev. 2 -2004)
Part 1 -Kept By Recording Office CAT. NO 6009r,x —