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1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)( c) Notice of Federal Tax Lien
(Rev. February 2004) 7Li, . uS-. 5' / J r: rL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 f.... fJ-1I R/'{,c'V
Lien Unit Phone: (800) 829-3903 209309105
As provided by section 6321,6322, and 6323 of the Internal Revenue Cl'- /.23 /
Code, we are giving a notice that taxes (including interest and penalties) Kep.
have been assessed against the following-named taxpayer. We have made 11-00/3
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 e "-'
c> 0
additional penalties, interest, and costs that may accrue. c,:;;;.) -l'l
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Name of Taxpayer JAMES WRIGHT & M WHITE WRIGHT ..C ,:, ~:- :~.T\
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Residence 111 MAY DR APT 4 '.i(..J
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CAMP HILL, PA 17011-5023 . ~~?'~ i~~
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IMPORTANT RELEASE INFORMATION: For each assessment listed below. - :JJ
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 Dal. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi ng of Assessment
(a) (b) tc) (d) (e) (f)
1040 12/31/2002 176-50-5327 09/01/2003 10/01/2013 6469.02
1040 12/31/2003 176-50-5327 05/17/2004 06/16/2014 5550.40
Place of Filing
Prothonotary
Cumberland County Total $ 12019.42
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
14th day of January
2005
Signature
Title
ACS
(800) 829-3903
23-00-0008
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rut. 71-466, 1971 - 2 C.B. 409)
Part 1 - Kept By Recording Office
Form 668(Y)(c) (Rev. 2-20041
CA T. NO 60025X