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Form 668 (Y){ c)
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
(Rev. Februarv 2004)
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
Lien Unit Phone: (412) 395-5265 222156105
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.
Name of Taxpayer JASON L HECKENDORN
For Optional Use by Recor iog Office
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Residence
202 GULL CT
MECHANICSBURG, PA 17055-2056
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 Day for Unpa' Balance
Kind of Tax Ending Identifying Number Assessment Refilmg of As ssment
(a) (b) c) (d) (e) (f
1040 12/31/2002 206-50-6591 02/09/2004 03/11/2014 4129.20
1040 12/31/2003 206-50-6591 02/07/2005 03/09/2015 7205.08
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
11334.28
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
06th day of April
2005
Signature
Title
ACS
(800) 829-3903
23-00-0008
for L LEDER
(NOTE: Certificate of officer authorized by Jaw to take acknowledgment is not essential to the validity of Notice of
Rev. Rul. 71-466, 1971 .2 C.B. 409)
deral Tax lien
Part 1 - Kept By Recording Office
Form 668( (c) IRev. 2.2004)
AT. NO 60025X