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1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
WAGE & INVESTMENT AREA #2 J~
Lien Unit Phone: 1800) 829-7650 214256405 0:: -1/55
As provided by section 6321, 6322, and 6323 of the Internal Revenue f/ JI-j, 00 "Pel
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, (!J::.... -.H /12L{~
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 /< -=JL
additional penalties, interest, and costs that may accrue, II.,/ ?>9'7
Name of Taxpayer MELVIN R HODGE r-->
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c~::.) .,
C-1"''I
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Residence r'l1---
458 N WEST ST ;;-"J r::-~
CARLISLE, PA 17013-1962 , ;~~
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, <~ ~~r~
unless notice of the lien is refiled by the date given in column fe), this notice shall, -- ~j\n
r:':)
on the day following such date, operate as a certificate of release as defined =2 :~i~
in IRe 6325Ia). '^'
'.D ".
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment RefilIng of Assessment
(a) (b) (c) Cd) (e) (f)
1040 12/31/1996 177-42-0848 05/19/1997 06/18/2007 353,15
1040 12/31/1997 177-42-0848 OS/21/2002 06/20/2012 1414,52
1040 12/31/1998 177-42-0848 06/14/2004 07/14/2014 3275.56
1040 12/31/1999 177-42-0848 06/21/2004 07/21/2014 3091.67
1040 12/31/2000 177-42-0848 06/21/2004 07/21/2014 2781,21
1040 12/31/2001 177-42-0848 05/31/2004 06/30/2014 2610,93
1040 12/31/2002 177-42-0848 05/31/2004 06/30/2014 3780.61
1040 12/31/2003 177-42-0848 05/31/2004 06/30/2014 2807,94
Place of Filing
Prothonotary
Cumberland County Total $ 20115.59
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
15th day of February
2005
the
for P S
Title
ACS
(800) 829-7650
12-00-0000
Signature
(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 G.B. 409}
Pan 1 - Kept: By Recording Office
Form 668(Y)(c) lRev. 2-20041
CAT. NO 60025X