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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 101600714 r� L
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. M UD
Name of Taxpayer FREDERICK W KOCH % r -
�� o
Residence 717 MARKET ST STE 342 ---
LEMOYNE, PA 17043 -1581 r "o
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
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)
1040 12/31/2009 XXX -XX -9113 10/15/2012 11/14/2022 4116.41
Place of Filing
Prothonotary
Cumberland County Total $ 4116.41
Carlisle, PA 17013
This notice was prepared and signed at DETRO MI
on this,
the 23rd day of May 2014
Signature Title
�-� REVENUE OFFICER 22 -06 -2614
for LINDSEY O BOWLIN (717) 777 -9623
(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)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2 -2004)
CAT. NO 60025X