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Form 668 (Y)(c)
{Rev. October 2000)
Area: I Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #3
lien Unit Phone: (412) 395-5265 230285463
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.
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optional Use by Recording Office
Name of Taxpayer RONALD BLYSTONE
Residence
1438 BRIDGE ST
NEW CUMBERLAND, PA 17070-1117
IlqPORTANT RELEASE INFORFJATION: 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).
Kind .of Tax
94O
94O
94O
941
941
941
941
Place of Filing
Tax Period
Ending
(h)
12/31/1999
12/31/1999
12/31/2000
12/31/1997
03/31/1998
06/30/1998
09/30/1998
12/31/1998
03/31/1999
06/30/1999
o9/3o/1999
12/31/1999
03/31/2000
06/30/2000
Identifying Number
(c)
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
25-1732635
Date of
Assessment
(d)
03/13/2000
01/07~/2002
03/19/2001
03/09/1998
06/21/1998
09/14/1998
12/21/1998
03/29/1999
06/21/1999
09/20/1999
12/20/1999
03/13/2000
06/26/2000
09/18/2000
Last Day for
Reflling
(e)
04/12/2010
02/06/2012
04/18/2011
04/08/2008
07/21/2008
10/14/2008
01/20/2009
04/28/2009
07/21/2009
10/20/2009
01/19/2010
04/12/2010
o7/26/2OlO
10/18/2010
Prothonotary
Cumberland County
Carlisle, PA 17013
Total
Unpaid Balance
of Assessment
1306.36
6833.79
172.78
3583.23
13538.88
13973.28
8991.95
12879.05
9256.72
8315.66
7066.85
12166.09
10929.86
6700.38
115714 . 88
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the 27th day of February 2002
Signature~~ ~~~--~--~:;~-~"'~ .~1 Title
· SPF ADVISOR 23-97-6921
for CARLO GONNELFn¢~ // I (215) 861-1931
(NOTE: Certificate of officer authorized by law to tak~'acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 6&8(¥)(¢) (Rev. 10-00)
Part 1 - Kept By Recording Office CAT. NO 60025X
FORM 669-C
(Rev. February 1992)
DEPARTMENT O]= THE TREASURY - INTERNAL REVENUE SERVICE
CERTIFICATE OF DISCHARGE OF PROPERTY FROM FEDERAL TAX LIEN
(Sec. 6325(b)(2)(B) of the Internal Revenue Code)
WHEREAS, Ronald Blystone
Of 1438 Bridge Street
, City of
New Cumberland
County of Cumberland , State of
is indebted to the United States for unpaid internal revenue tax in the sum of (he
Seven Hundred Fourteen & 88 Cents Dollars($ 115,714.88
Pennsylvania ,
Hundred Fifteen Thousand
as evidenced by:
NOTICE OF FEDERAL
TAX LIEN RECORDING DATE TAXPAYER IDENTIFICATION AMOUNT SHOWN
SERIAL NUMBER INFORMATION RECORDED NUMBER ON LIEN
(a) (b) (c) (d) (e)
230285463 ' 02-1219-FTL 03/12/02 25-1732635 $115,174- 88
WHEREAS, to secure the collection of said tax, notice of the lien of the United States, .attaching to all the
property and rights to property of the said taxpayer on account of said tax indebtedness, was filed with the
Office of the Prothonotary forthe
County of Cumberland , and als0 with the XXXXXXXXXXXXXXXXXXXXXXXXXXXXX
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX , in accordance with the applicable provisions of law.
WHEREAS, the lien of the United States, listed above, for said tax has attached to certain property described as:
See attached description signed and dated by authorized delegate.
Pennsylvania Liquor License~ R-265
Catalog No. 16753Y Form 669-C (Rev. 2-92)
(Use this space for continued description of property)
WHEREAS, the District Director of Internal Revenue has determined that the interest of the United States in the
foregoing property, under and by virtue of its aforesaid tax lien, is now valueless;
NOW, THEREFORE, THIS INSTRUMENT WITNESSETH, That I, _J3. F o Rogers
District Director of Internal Revenue at Penns~flvania , charged by law with
the duty of collecting and enforcing the collection of internal revenue taxes due the United States, and charged with the
assessment hereinbefore stated, do, pursuant to the provisions of section 6325(b)(2)(B), of the Internal Revenue Code
discharge the property heretofore described from the aforesaid tax lien, saving and reserving, however, the force and
effect of said tax lien against and upon all other property or rights to property to which said lien is attached, wheresoever
situated.
the
WITNESS my hand at Philadelphia, PA
day of October
,xsgoo2
, on this,
S'O.A~U.E ~ ~
Charles W. Dinah Jr. ~-L- TITLE
' Technical Support Group Manager
(NOTE: Certificate of of~cer authorized by law to take acknowledgments is not essential to the validity of D~scbarge of
Federal Tax Uen. Rev. ~u[. 7~-466, ~97~-2, C.8. 409.)
FORM 66~C (Rev. 2-92)
* U.S. Government Prinfi~ ~: 1~2 - 312-711[5~6