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7952
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
SMALL BUSINESS/SELF EMPLOYED AREA #3 O~ -1f~O 5'-rC~
lien Unit Phone: (412) 395-5265 214737205
As provided by section 6321, 6322, and 6323 of the Internal Revenue V/4.o0.f:Jd..
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, e~ / J./{p
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 /J..di- I ltl.{ 63...-
additional penalties, interest, and costs that may accrue.
Name of Taxpayer DONALD J MCCORMICK N C)
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Residence -:''' hi ::J
3797 CHESTNUT ST ....-'''' r-
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CAMP HILL, PA 17011 I '..'y'
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IMPORTANT RELEASE INfORMATION: For each assessment listed below, ~:2?q
unless notice of the lien is refiled by the date given in column (e), this notice shall, . 2:3 ,~in
on the day following such date, operate as a certificate of release as defined - '~2 ..
in IRC 6325Ia), ,:-
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refihng of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1997 194-52-5380 OS/25/1998 06/24/2008
1040 12/31/1997 194-52-5380 02/07/2000 03/09/2010 483.53
1040 12/31/1998 194-52-5380 06/07/1999 07/07/2009 3457,84
1040 12/31/1998 194-52-5380 10/16/2000 11/15/2010 1202.00
1040 12/31/2002 194-52-5380 06/02/2003 07/02/2013 230,77
Place of Filing
Prothonotary
Cumberland County Total $ 5374.14
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
16th day of February
2005
Signature
12-00-0000
for P S
Title
ACS
(800) 829-7650
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Ru!. 71-466, 1971 - 2 C.B. 409)
Part . ~ Kept By Recording Office
Fo'm 668(Y)(c) IRev. 2-20041
CAT. NO 60025X