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lForm 668 (V)
I(Rev. Oelebuf 1993)
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THIS t'lCl1llE CORr,E,(TS (If,H,!~IA, r,l(' 1 I'~"
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Department 01 the Treaeury . Internel Revenue Sorvlce
Notice of Federal Tax Lien
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Serial Number
For Oplional Uso by Rocordlng Ollie'
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As provided by sections 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 followlng.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 rlghta to
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, Interest, and costs that may accrue.
IName of Taxpayer DUNALD L ~, L) t-JDA L EM!'-'! 1 !OLD
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IResidence 414 S fRElJERICV 51
I MECHANICSBURG. PA 110~5641U
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of 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 IRC06325(a ~RE(:lS CIR I C; 1 NAL (,4 TF i i.J. ,"'L . (r- . ~ ..'..
Tax Period Date of
Ended Identifying Number Assessment
(b) (e) (d)
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Kind of Tax
(a)
C.lLtlll eN,'
i<.t! 8301.~
Last Day for Unpaid Balance
Reflllng of Assesament
(8) (f)
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1')4') 12/:.:<1/87
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':;'J086,.Ol
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,Place at Filing
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F'roth.:.n.:.tiu' ~:
Cumbet.land C')unt)
Cat. I i !i II:!, PA 1 tn 1';:
Re-Cl)f"d i ng Data.: -,
':1: O!j ::4 ': '~;:38
Total
$
';')086.01
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This notice was prepared and signed at
P~1 I I (1.de I pil j ;\ 1 F',A ~
,on this.
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',the ::'7 Ie. day of ~1"'1 ,. h
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Signature ,_ ' I Title '.. " ; "t. c.;. r' . [: .
(NOTE: Ccrtlrlcatc ot ollicer .1urhorl~q,g)~~ law to take acknowlodgmonts is nol ossunlml to Iho validity 01 Notice of Foderal Tax lion
Rev nu,. 71,466, 197' .2 C.B, 409)
Part 1 _ Kept By Recording Ofllce Form 668 (V) (Rev. 10-93)
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Form 668 (2) : ~;: { J Department 01 the Treaaury . Internal Ravenue Service
IR..., b-'J4) Certificate of Release of Federal Tax Lien
District Sa rial Number For U.. by Rlcordlng otllcl
l~'h I 1<1..1;,-.1 nh Ii. i ,^ ~' : ,", , . ',"I
I certify that sa to the lollowlng-nama taxpayar, the requlrementa at section 6325 (al
01 thalnternal Ravenue Coda have been IItlslled tor the taxes listed below end lor
all atatutory addlllons. Therelore, thallan provided by Code secllon 6321 lor these
taxea and addlllona haa been releelld. Tha proper olllcer In the olllce where the ~-.:.:: '
notlco ollnlernal ravenue tax lien waa tIIod on {l. [" ,1 ':..., r-
19 ...:.:::... la In authorized to note tha books to ahow tho release 01 this lien lor t":"
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these tuxes and addlllona
Nome 01 Toxpayerlil)t-IAI. Ii C,"
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ttlE~("Il.AN I I: (,:~r;l~l~;(l' F/-.. , ' ' ,;~.'_:, - 1;.41 \,.' c.n
, OUf-( r ',U:,CiRD 1 NG INFI)fd'lf' 11 Oil: ,lISt.:;u\>d
L i r"!I' F' <:t. ~1 t~ U"C Illu.. '.:>::! " I ;1 I I',J'.' a
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n/a ni a 1'1/ :) . ...~- 17:,-,",1'+,1 c.\.loU Sa~5q RII d.,q:"',()
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Tox Period Dote 01 Lost Day lor Unpaid Balance
Kind 01 Tax Ended IdenUlylng Number Assessment Rellllng 01 Assasament
{a} {b} Ie} Id} la} II)
1.040 L:I :: 1/ :::7 l7 ..;.,,- ~'4-':~'; ~:.::' , - - ,. ('.-1('.,/_.;.. ! ,)':' <.)086. I) 1
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Place 01 Filing
Pt ,) t h.) fl '_' t i\ ('.r' Total $
('ulnb c!" 1,!llf1 ollllt ,.,(\:--;(-, . ('1
Car i i'.lt,. }<'fl.. /Ili '0;,
This nolicb was prepared and signed at
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Title
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INOTE: CtJ,j:/CiJI6 ct elf,(t.',:iUmorilea by 1,1"" 10 r.J~B "II.no",:cel1ments,s lIel t.lSS(lf1r'.11 to tho v01:,dty of c,rr,fJcaf, 01 Release 01 Fed,ral nu' 'ill" R,v. Rul, 7'.466. '97'-2
C B 409)
PAnT' . RECORDING OFFICE Form Ole (Z)(Rov, 5-94)
CAT. NO eoo201
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