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1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004} Ylh,OC ,,-r<:',/ F/I
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESs/sELF EMPLOYED AREA #3 €t. P'-'-/-I < n..N
Lien Unit Phone: (800) 829-3903 256180605
As provided by section 6321, 6322, and 6323 of the Internal Revenue elL 477:J.J
Code, we are giving a notice that taxes (including interest and penalties) fL. 17020'1
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. (") ~
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Name of Taxpayer THOMAS E BARD ._,'.- :2,.
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Residence 18 BARD RD CJ ~:~~ ~~~
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SHIPPENSBURG, PA 17257-8143 - -0
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, .. ~~-(
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unless notice of the lien is refiled by the date given in column (e), this notice shall, CO -<
on the day following such date, operate as a certificate of release as defined
in IRe 6325(al.
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilmg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2004 168-60-1751 06/06/2005 07/06/2015 1098.35
Place of Filing
Prothonotary
Cumberland County Total $ 1098.35
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
27th day of October
2005
Signature
a. I/~
Title
ACS
(800) 829-3903
23-00-0008
for L LEDER
(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. 4091
Part 1 ~ Kept By Recording Office
Form 668(Y)(c) (Rev. 2-20041
CAT. NO 60025X