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Form 668 (Y) Deperlment olthe Treuury . Inlernal Revenue Service
'(R.v, October 1993) Notice of Federal Tax Lien
District Serial Number For Optional Uu by Recording Olllce
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AI provided by sections 6321, 6322, and 6323 01 the Internal Revenue FTL
I Code, we are giving a notice thattalles (Including Interest and penaltlel)
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j a demend lor payment 01 this lIeblllty, but 11 remalna unpaid. Therelora,
I there Is e lien In lavor 01 the United States on all property and rlghtl to
i property belonging to this tallpayer lor the amount 01 these talles, and s=-...
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I additional penalties, Interest, and costs that may accrue. ...
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IName of Taxpayer '"ERI\LD E ELL I:;; .
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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, ~ 1/l114
on th~ ~ay f~i~wlng such date, operate as a certificate of release as defined "'9.00 juJ.. ~~ ~g99S'
In IRC ~25(a .'C,'=""Tc- ,~'c, ,-. I "'hi n c. n~ ".. , ", . ", ~..
, Tell Period Dete 01 Last Day lor Unpaid Balance
, Kind 01 Tall Ended Identllylng Number Assessment Rellllng 01 Anellme"t
, (a) (b) (c) (d) (9) (f)
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~ Place of Filing F','..-,th.-,rl(.t tlt"",
, Cumber I dr.d ( -:lur.t.'! Total $ j .~,:'-::I':.(,. :'~:O
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This notice was prepared and signed at
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. on this,
the ,,' oj day or"" I ;'1'9_.
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Signature -' ,.' '" -' I Title,!. '"
(NOTE: Certlllcilto 01 ollicor aulho"rllo'd by 1.1w to lako acknowledgments is not ossontial to tho valldily 01 Nollce 01 Fodoral TalC lion
Hov. flul 71.466, 197t . 2 C B. 409)
Part 1 . Kept By RecordIng Olllce Form 668 (Y) (Rev. 10.93)
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Form 668(Z) Ilq 1
(Rev.8-97)
Department of the Treasury - Internal Revenue Service
Certificate of Release of Federal Tax Lien
District
Serial Number
For Uae b Recordln Office
PENN:;'y'LVANIA 23".140412<;;
I certify thattha following-named taxpayer. under the requirements of section 6325 (e)
of the Interne I Revenue Code has satisfied the taxes listed below and all statutory
additions. Tharafore, the lIan provided by Code section 6321 for Ihese taxes and
additions has been relaased, The proper officer In the office where the notice of
Internal revenue tax lien waa flied on /I, p r ,I 19 .
1':194, Is authorized to note the books to show the release of thla lIan for
these taxes and additions,
Name of Taxpayer
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Residence
4408 CARUSLE P II<E
CAMP HILL. PA 17n11
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COURT RECORDING INFORMATION:
L,ber Page UCC Na.
n/a n/a n/a
Kind oITax
(a)
Tax Period Ended Identifying Number
(b) (c)
Se,',..l N'J.
94-2(1PFTL ~II
Date of Last Dsy for
Assessment Reflllng
(d) (8)
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Unpeld Balance of
Assessment
(f)
6672 09/30/1986 115-36-(1707 05/30/1988 ')15/29/1998 12950.80
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Place of Filing
12950 .8('
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ProthonClL!lI'V
Curuberland County
Carlisle PA 17013
Total
$
This notice wes prepared and signed at
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,on this,
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the
22nd day 01 toIav
19ge
Signature
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Tille
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(NOTE: Certificate of offtefJr ,ulhonzod by law to t.ke acil;.lOJf'edgfllftnlJ 15 no' OJuntial'o 'he validity of Certificate of Release of Federal Tax lien Rw. RuI. 71-468, 1971.2 C.B. 409)
PART 1 . RECORDING OFFICE
Form sea (ZJ (Rev. 6.97)
CAT, NO 600261
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