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Form 668 ff)(c) Department of the Treasury - Internal Revenue Service
(Rev.February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESSISELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 1 130981714 740 42
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 -.0
property belonging to this taxpayer for the amount of these taxes, and =t-*, c-"l
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additional penalties, interest, and costs that may accrue.
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Name of Taxpayer HEINLY III MASONRY LLC
Residence 275 CUMBERLAND PKY STE 308
C7)
MECHANICSBURG, PA 17055
IMPORTANT
IMPORTANT RELEASE INFORMATION: For each assessment listed below, 77
unless notice of the lien is refiled by the date given in column (a), this notice shall,
notice
P 0:�
le s
� I
on the day following such date, operate as a certificate of release as defined
C 6
in IRC
o 6325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) W (d) (e) M
940 12/31/2013 46-2196054 05/05/2014 06/04/2024 201.34
941 09/30/2013 46-2196054 12/02/2013 01/01/2024 3662 .28
941 12/31/2013 46-2196054 03/31/2014 04/30/2024 2573 .45
Place of Filing
Prothonotary
Cumberland County Total 6437 . 07
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 19th day of November 1 2014.
Signature REVENUE OFFICER 22-06-2614
for LINDSEY 0 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) Office Form 668(Y)(c) (Rev. 2-2004)
Part I -Kept By Recording
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