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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 993593714 ,�y _
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
property belonging to this taxpayer for the amount of these taxes, and '
additional penalties, interest, and costs that may accrue. c
Name of Taxpayer K C DILTZ & K M FOJUTOWSKI - DILTZ <C "„
- -
Residence 127 YORKSHIRE DR -
MECHANICSBURG, PA 17055 -3533
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, sib G�- �q
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 Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2009 XXX -XX -8260 06/07/2010 07/07/2020 16383.92
1040 12/31/2010 XXX -XX -8260 05/23/2011 06/22/2021 7608.38
1040 12/31/2011 XXX -XX -8260 06/04/2012 07/04/2022 5115.73
1040 12/31/2012 XXX -XX -8260 06/10/2013 07/10/2023 8588.44
Place of Filing
Prothonotary
Cumberland County Total $ 37696.47
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 08th day of April 2014
Signature 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( (Rev. 2-200
Part 1 - Kept By Recording Office CAT NO 60025X X