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3114
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(C)
(Rev. February 2004)
Notice of Federal Tax Lien
fu.."O (.,. Lo S <.f P r: '\L
For Optional Use by Recording Office
Area: Serial Number
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 322704306
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.
Name of Taxpayer THOMAS E SITES
Ill- Pll" Jif.~
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f2.u.r. / fY 9/3
Residence
APO BOX 1154
MECHANICSBURG, PA 17055
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IMPORTANT RELEASE INFORMATION: 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
(a)
1040
1040
Tax Period
Ending
(b)
12/31/1993
12/31/1994
Identifying Number
(c)
XXX-XX-2915
XXX-XX-2915
Date of
Assessment
(d)
05/19/1997
04/21/1997
Last Day for
Refiling
(e)
06/18/2007
OS/21/2007
Unpaid Balance
of Assessment
(f)
291092.02
2053.35
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $
293145.37
This notice was prepared and signed at
DETROIT, MI
, on this,
the
17th day of October
2006
Signature
Title
ACS
(800) 829-7650
11-00-0000
for DEBRA K. HURST
(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. 409)
Part t . Kept By Recording Office
Form 668{Y){c) (Rev. 2-2004)
CAT. NO 60025X