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!Form 668 (V)
'IR,v. OclObl' 1093)
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Department 01 the Trealury - tnlernal Revenue Service
Notice of Federal Tax Lien
Serial Number
For Optional Usa by Record/ng Olllce
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As provided by sections 6321, 6322, end 6323 01 the Internal Revenue
Code, we ere giving a notice that texes (Including Interest and penalties)
have been essessed against the following-named taxpayer. We ha\le made
a demand for peyment of this IIsblllly, but II remains unpaid. Therefore,
there Is e lien In fa\lor of the Unlled Slales on all property and rights to
t property belonging to this taxpsyer for Ihe emount of these lexes, and
I additional penalties, Interest, and costs that may accrue.
lName of Taxpayer; il'l A r lI',FHEF
I i'-I.;~ j Itr1 II (JUT r">~ HAL!
\Resldence ,_<:, 7'.' .:; rRA [IiI'l''''''l, [,\f,
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IMPORTANT RELEASE INFORMATION: For each assessment IIsled below,
unless notice of lien is refiled by the date given in column (Il), this notice shall,
on the day following such date, operate as a certificate of release as defined
in IRC 6325 a .
Tax Period
Ended
(b)
c.i.<.. ti ., 3~o.5
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Unpaid Balance
of AsseBBment
(f)
Kind of Tax
(a)
Identifying Number
(e)
Date of
Assessment
(d)
Last Day for
Reflllng
(e)
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(NOTE: Cf'rllllcato 01 ollicur aulhOrtlOd by law 10 lalo-.o ;)clo-.nowlodgml.:'l1ts 's nol ossenllal to the validity of Notico ot Federal Tall. hen
Rev, Aul 71.466,1971.2 CoB, 409)
Part 1 . KepI By Recording Office Form 668 (V) (Rev, 10,93)
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499
Depertment of the Treesury - Internel Revenue Service
Certificate of Release of Federal Tax Lien
Fonn 668 (1)
IR..... 1()..2000)
Aree: Seriel Number
SMALL BUSINESS/SELF EMPLOYED AREA "3
Lien Unit Phone: (412) 395-5265 239404630
I certify thet Ihe following-named taxpayer, under the requirements of section 6326 la)
of the Internal Revanue Code has satisfied Ihe taxes listed below and all statutory
additions. Therefore, the lien provided by Code section 6321 for these taxes and
eddltlons has been released. The proper olllcer In the olllce where Ihe notice of
Internal revenue tax lien was filed on April 26
1994 ,Is authorized to note the books to show the release of this Iian for
these taxes and additions.
Nama of Taxpayar
KIM A FLETCHER
FKA KIM A GOTTSCHALK
For Usa b Recordln Oll/ce
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Rasidence5270 STRATHMORE DR
MECHANICSBURG, PA 17055-0000
RECORDING INFORMATION:
Serial No.
94-2176ftl
,'.
COURT
Page UCC No.
n/a n/a
Tax Period
EndIng
Ib)
12/31/1990
******* .*.*******
Liber
n/a
D.1Ite of
Assessment
Id)
06/13/1991
**********
wt D.1IY for
ReRllng
Ie)
07/13/2001
************
UnJJ.1lld B.1Il.1nce
of Assessment
(f)
195393.76
****************
KInd of Tax
la)
6672
Identifying Number
Ie)
572-27-4538
.************
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
195393.76
Total $
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This notica was prepared and signed at
PITTSBURGH, PA
. on this.
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the
26th day of May
I,
2002
~
Slgnatur
Title Compliance Technical Support
Manager
(NOTE: Cortificato of oUicer authorized by law to 18 0 acknowledgments is not 8550nlial to the validity of Certificato of Release of
Fodora' Ta.lion Rov, Ru!. 71.466.1971 .2 C,8, 4091
Pan I . RECORDING OFFICE
Form 668 (Z) IRov, 10,20001
CAT. NO 600261
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