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499
Department of the Treasury - Internal Revenue Service
Fonn 668 (Y)(c) Notice of Federal Tax Lien
(Rev. October 2000) llD. O.J.. lof 7 FT/...
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 IJ.. ; 9 ,tTl),J~
Lien Unit Phone: (800) 829-3903 230285324
As provided by section 6321, 6322, and 6323 of the Intemal Revenue cJ... 10(,
Code, we are giving a notice that taxes (Including Interest and penalties) ~ 1:1.7"1'7
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. 0 0 0
C f'..l '>Tl
Name of Taxpayer SUSAN E FASICK s: ::r.
uc;' ~';7a ''] ~~
FASICKS STYLING STATION rT1n" ::;iJ
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Residence -<-"" ' '
1908 CARLISLE RD ~c.-; I ~-;)
CAMP HILL, PA 17011-5911 J:11" " ~.)' ~
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, ~ j::"' jJ
unless notice of the lien is refiled by the date given in column (e), this notice shall, \0 -<
on the day fOllowing such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Dr.r. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Ref! ng of Assessment
(a) (b) (c) (d) (e) (f)
940 12/31/1993 25-1666763 10/28/1996 11/27/2006 251.17
940 12/31/1994 25-1666763 10/28/1996 11/27/2006 71.64
941 09/30/1993 25-1666763 09/19/1994 10/19/2004 2129.68
941 12/31/1993 25-1666763 09/26/1994 10/26/2004 2075.28
941 03/31/1994 25-1666763 01/01/1996 01/31/2006 1726.74
Place of Filing
Prothonotary Total $
Cumberland County 6254.51
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
26th day of February
2002
the
Signat
for
Title
ACS
(800) 829-3903
23-00-0008
(NOTE: Certificate of officer authorized by law t
Rev. Ru!' 71.466. 1971 . 2 C.B. 409)
ke acknowledgment is not essential to the validity of Notice of Federal Tax lien
Part 1 - Kept By Recording OffIce
Form 668(Y)(c) IRev. 10,00)
CAT. NO 60025X