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12460
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) lk6j--L73/ FTL.
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 (Jdv Pf!( 91VUu
Lien Unit Phone: (800) 913-6050 242147305
As provided by sectian 6321, 6322, and 6323 af the Internal Revenue 12.1:... /1. ,/3
Cade, we are giving a natice that taxes (including interest and penalties)
have been assessed against the fallowing-named taxpayer. We have made fL 17,;.1 ,,},-'
a demand for payment af this liability, but it remains unpaid. Therefare, . '/7
there is a lien in favor af the United States on all property and rights ta
praperty belonging to this taxpayer for the amount af these taxes, and
additional penalties, interest, and costs that may accrue. .....,
ion 0 ~." 0
Name of Taxpayer JAM ELECTRICAL SYSTEMS INC a Corpora ~; <= 'TI
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Residence ", rTl
1914 BROOKWOOD ST c:
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HARRISBURG, PA 17104 : .. ,
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, j.;-. '" (',":) fT.
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unless notice of the lien is refiled by the date given in column (e), this notice shaH, ;;~..
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on the day following such date. operate as a certificate of release as defined 01 -<
in IRe 6325(a),
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)
941 06(30(2003 25-1848847 11(17(2003 12(17(2013 27453.96
Place of Filing
Prothonotary
Cumberland county Total $ 27453.96
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the
08th day of August
2005
Signature
tl fI'~
RE
Title
or CINDY
OFFICER
23-09-1459
(NOTE: Certificate of officer authorized bV law to take acknowledgment \s not essential to the validity of Notice of Federal Tax lien
Rev. Ru!' 71-466,1971 - 2 C.B. 409)
Part t - Kept By Recording Office
Fo,m 668(Y)(c) IRev, 2-2004)
CAT, NO 60025X