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'II"", 0""1>,, ""JI~ Notice of Federal Tax Lien
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, AI provided by secllons 6321, 6322, IInd 632:1 (It llie InlllrtHlI ncvunuIJ
Code, We ere giving a nollco thol IIIKOS (Incllldlllll IlIlele,;1 lInd punlllllos)
hive been all8essei agalnsllhe followlng-numud tllxpnyer. Wo hovo modo
I demlnd for psyment 01 this lIabllllY, bul It ICI11I1II1~ IIIIPllld, Therl.l'om,
there II a lien In lavor 0' the Unllod Slolcs on 1111 plopcrty IInd rights 10
property belonging to Ihls taxpayor lor Iho 0111011l1t 01 theso IOxus, end
Iddltlollal pellallles, Interost, ond cosls thalil10y IICCIlIU,
ame of Taxpayer
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IMPORTANT RELEASE INFORMATION For eaell '''i:;e,i':l1wnIIISlod below,
unless notice at lion 15 reflled by IflU dalo aiV1JI1111 <;011111111 ('.!). 1111:; l10lice 511<111,
on the day follOWing such dalo, opuralU as II certllicalu 01 ,ul'la:,n ac, dolll1od
In IRC 6325(a .
Tu Period
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I Kind of Tu
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Identifying Number
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Dale 01
Assessmenl
101)
Losl Day for
Rullllng
(0)
Unpaid Balance 1 ,
of Assessment
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Total $
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iThiS notice was prepared ond siannd al _ ,
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1,),," 6GI) (Y) Ifln" 1093)
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,.... 668(Z) Deplrtmenl ollhe T..llury , Intl,nll Rlv,nul IServle.
Certificate of Release of Federal Tax Lien
\..... .". .1Il1
Dl.tnet Berl.1 NumDer 'OI Optlonll UN by "",..
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Philll<ll!lphill, I'A 239/.104M'I
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I eltl1lly that .. 10 lhe fOllowlng.n.med Inp.yer, Ihe requlr.m.nl. of .ecllon 6325
(.) of lhe Inl.rn.1 ...v.nu. Cod. h.v. been ..II.f1ed lor th. I.K.. lI.ted below .nd
for .11 .I.,utory .ddltlon., Th.r.for., th. lI.n provld.d by Cod. ..ellon 1321 for
tlM..tn.. .nd .ddlllon. h.. been r.I....d, Th. proper olllear In th. ollie. wh.r.
th. nollDl of Inl.rn.' r.v.nu. tn II.n w.. flied on SI!lltl.'I1II"'r 7. ,
18 -2!L, I. .uthorlled 10 nol.lh. books 10 .how th. r.,.... of thl. II.n for Ih... " -. ,',
..... .nd .ddlllon., , ", "
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...m. or TeKpay.r , )
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liAr, H WI !.SON ...., :I:r'
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TIlAVE!. ACTS I NT Ell NAT!. OF CAMP Ill!.!. " .()
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....ld.ne. --;
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"'100 IIAH'J'WAJ.l-, 1m , r;~';J _.>"11
CAMP 1111.1" I'A 170 II ,'-, !
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COUIlT RECOIlOlNC I NFOHMAT ION: SElllA!. 1/94-5016FTI. ~v....'" I'll:)
R ~ .~rJL\..l1
T'K P.rlod' 0.1.01 L..I O'y for Unpaid B.I.nee
Kind of T'K Ended Id.ntlfylng Number An...m.nt Rellllng of A.....m.nt
II) Ib) Ie) Id) It) (F)
941 03/31/90 25-1574289 06/27/94 07/27/04 1700.84
941 06/30/90 25-15742B9 05/']0/94 06/29/04 1293.99
941 09/30/90 25-157/.289 06/06/94 07/06/04 1637.00
941 12/31/93 25-157428'1 05/30/94 06/29/04 3026,55
940 12/31/93 25-1574289 06/27/94 07/27/04 138.2/,
************ *********** ~**************** *********** idf********* ***********************
r cenify th t under thl' provisions of [RC Sect ion 632 , the filin of the Not ice of
Federal Tax ien Unde r [ ternn I. RtJvenul.' La under [He e...Uon 6321 was erroneous.
Therefore, t e Not ice of Federal Tux Lien nder [n tern 1. Revenll~ L w for the tnxes
iAtl'd abovl! I aH been reI ased.
************* *********** *****;~*********** *******"c*** *********** ***********************
PI.c. of Filing
PROTHONOTARY S 7796.62
CUMBERLAND Cl)UNTY COURTHO!JSI'; Tol.1
CARL[SLE. PA 17013
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Itlw /I) IjJ"" tlcllnowl1fdg6n1ellfS I/i nor tl8!len/lallo In" V,11Idl'~ of (Hr1IIICIUtJ 01 ApIH,1,G8 01 FNffRl Tax (11m R." Rul ".4ed, 19",2
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CA T NO eOO211l
Form Ml(Z) (Rev, 4-84)
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