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Form 668(Z) l'1.q ~ Department of the Treaaury - Internal Revenue Service
(Rev,e'97) Certificate of Release of Federal Tax Lien
Dlatrlct Serial Number For Uee by Recording Office
PENH::;'(LVANIIl, 2'3'='11114 tiC:
I certify that the following-named taxpayer, under the requlremente of eectlon 6325 (a)
of the Internal Revenue Code haa satlslled the taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 lor these taxes and "1 .(;1 C1
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addltlona has been released. The proper officer In the office where the notice 01 ~~) ~ . r H'
Internal revenue tax lien was lIIed on AI','i! J q o'
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1 '='9'1, 10 authorized to note the books to ahow the release :If this lien for . , :..:> :.,nl
these taxes and additions. c...: '0
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Name 01 Taxpayer "::J
L RONALD ANOEP'SOI'1 ~. ~()
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Residence 1'10 S'[ ,JOHNS DH '0 ~
CAMP HILL. PA 17011
COURT RECOROING INFORMATION: .lI5.OJ~
L. i b~r' Pa.]e UCC No. Ser',a! ~") . OAiI loj~\
I'l.la ../01 ,..lEl 94-2011FTL (l.t\ """0"\
.Klnd 01 Tax Tax Period Ended Identifying Number Dale of Lest Day for Unpaid Balance of
Assossmenl Reflllng Assessmenl
(a) (b) (e) (d) (e) (f)
lr)40 12/31/1987 191-32-3814 05/3')/1988 06/29/1998 9813.39
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Placo 01 Filing
Pr<>tto<>nc.t<<ry Tolal $
CWuber'lano1 Count.y 9813.39
CArl i~'" PA 17()1::l
This notice was prepared and signed al
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,on Ihls.
Ihe
:<:;;0..,1 day of t~<<\'
jqqe
Slgnaturo
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Title
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(NOTE: Certificate of o"icer Butoonzod by law to ra~e acJ/.llO'WIedgrntJnts is not essential to tho V;J{;citty of Certificato of RsloBSS of Federal Tb.lien Rov. Rut. 7'-468, 19n.2 c.B. 409)
PART 1 . RECORDING OFFICE
Form eea (Z) (Rev, 8.971
CAT. NO 600281
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Form 668 (Y)
(A.v. October 1993)
Depertment 0' the Treeaury . Internal Ravanua Service
Notice of Federal Tax Lien
District
Serial Number
For Optional Usa by Racordlng Olllcs
C'h I r _Ide: r' hi:)
'.jl..:j 11'
No.
94. ;10/1
FTL
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
I a demand for payment of this liability, but It remains unpaid. Therefore,
I there Is a lien In favor of the United Stales on all property and rights to
1 property belonging to Ihls taxpayer for the amount of these taxes, and
I additional penalties, Interest, and costs that may accrue.
I
iName of Taxpayer L c,I)ljALD AI'lCi[F,~;(IN
I
I
I Residence
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N
N
a:l
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! Kind of Tax
(a)
l.il) ~~ r J(!HNS Dh'
"f,J~F' HiLL, F'A 17')'1
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IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of lien Is reWed by the date given In column (e), this notice shall,
?n the day following such date, operate as a certificate of release as defined <II
mIRC.6325{a),'~'''(.TC' ..r,[' "M.. I',He: ",' "", ,... ~.DO
Tax Period Date of Last Day for
Ended Identifying Number Assessment Reflllng
(b) (c) (d) (e)
1- ;'
4" .~
~.
~ tl -JI Y7Y
ct. ~
~co-l. 'i'997
Unpaid Balance
of Assessment
(f)
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!Place of Filing
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F'r-.) t h ,~. fl U t d" "
Cumber I :-tr,,] _ ,>ur,t,
C a I lis Ie. F'.\ 1 ;'" 1 ::
h'pr,",t-dtrl'l D;)t:t-i: ~.
Total
$
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11.:, : J.:l : 1 (I! ':..~ l 'f ~>
'This notice was prepared and signed at
~"h I I ", ".-. t l'~j I ~ _ f-'t~_
, on this,
the
t-! day of.pt- ; I
,19_,
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(NOTE: ClHlI!!Cillo 01 olflcor auth'O;ilOd by law to tako acknowlodgmenls is nol essontial to the validily 01 NaileD 01 Fodoral Tax lion
Rev Rul, 71-466, 1971 .2 C.B. 409)
I
Part 1 . KepI By Recording Office
Form 668 (Y) (Rev, 10.93)
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