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1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien r'wos <(uo Fn,
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 ~'CPW K 1'1 ui)
Lien Unit Phone: (800) 829-3903 208123905
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck.- 1.1.3/
Code, we are giving a notice that taxes (Including interest and penalties) ~ /& UM.&
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. ("-~:;:p 0
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Name of Taxpayer ROBERT C & MARIE L JOLLIFF '- --1
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Residence 1201 DICKINSON DR l ~f;-~
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CARLISLE, PA 17013-4450 -":.>" (::)
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IMPORTANT RElEASE INFORMATION: For each assessment listed below, ~I"
unless notice of the lien is refiled by the date given in column (e), this notice shall, i'-)
on the day following such date, operate as a certificate of release as defined
in IRe 6325(a),
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment RefllIng of Assessment
(a) lb) (c) (d) (e) (f)
1040 12/31/1996 514-09-6541 02/09/1998 03/10/2008 5586,34
1040 12/31/1998 514-09-6541 11/29/1999 12/29/2009 1855.49
1040 12/31/1999 514-09-6541 09/02/2002 10/02/2012 8756.99
1040 12/31/2002 514-09-6541 10/18/2004 11/17/2014 2955.79
1040 12/31/2003 514-09-6541 10/18/2004 11/17/2014 2686.24
Place of Filing
Prothonotary
Cumberland County Total $ 21840.85
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
07th day of January
2005
Signature
Title
ACS
(800) 829-3903
23-00-0008
for L LEDER
(NOTE: Certificate of officer authorized by taw 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 I - Kept By Recording Offlce
Form 668(Y)(c) IRev. 2-2004)
CAT. NO 60025X