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6755
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) ~_O(.. '/.2 YO FT'-
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2 fa, P-Y/ ; 1'-1 . Vi)
Lien Unit Phone: (800) 913-6050 303784206
As provlcled by secdon 632 t, 63%2, and 6323 of the Intemalllevenue C-k- c,so.{
Code, we are giving a notice that taxes (Including Interest and penalties)
have been assessed against the followlng-named taxpayer. We have made ~- I fo ? '1 ~
a demand for payment of this liability, but It remains unpalcl. 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 0 ""
additional penalties, Interest, and costs that may accrue. C-:"l
("' r~')
i:;r.
Name of Taxpayer JAN OSTERLUND -"', c__ -1
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Residence PO BOX 590
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NEW CUMBERLND, PA 17070-0590 -,
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, - j.,)
unless notice 01 the lien is refiled by the date given in column (e), this notice shall, l_"-
on the day following such date, operate as a certificate 01 release as defined
in IRe 6325(a).
Tax Perlocl Date of Last DiJ. for Unpalcl Balance
Kind of Tax Ending Identifying Number Assessment Ref! ng of Assessment
(a) (b)- (e) Cd) Ce) en
1040 12(31(2002 XXX-XX-4842 11(10(2003 12(10(2013 1709.29
Place of Filing
prothonotary
Cumberland County Total $ 1709.29
Carlisle, PA 17013
This notice was prepared and signed at
DETROIT, MI
, on this,
the
19th day of July
2006
Signature
Title
ACS
(800) 829-3903
22-00-0008
for REGINA OWENS
(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 __rdlDS 0tIIce
Form 668(Y)(c) (Rev. 2-2004)
CAT. NO 6OO25X