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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(¢)
(Rev, October 2000)
Area: I Serial Number
WAGE & INVESTMENT AREA #2
lien Unit Phone: (800) 829-7650 230294722
j0~s provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are ~Iving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien Jn favor of the United States on all property and rights to
property belonging to this taxpayer for the amount of these taxes, and
Notice of Federal Tax Lien~.o~' v~_~¢ ~-r~
For Optional Use by Recording Office
additional penalties, interest, and costs that may accrue.
Name of Taxpayer CHARLES E BRINER III
Residence 311 HUMMEL AVE APT 5
LEMOYNE, PA 17043-1951
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the 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 IRC 6325(a).
Tax Period
Ending
(b)
12/31/1997
12/31/1998
Identifying Number
(c)
188-56-1126
188-56-1126
Date of
Assessment
(d)
10/11/1999
01/08/2001
Prothonotary
Cumberland County
Carlisle, PA 17013
Last Day for
Refiling
(e)
11/10/2009
02/07/2011
Total
Kind of Tax
(a)
1040
1040
Place of Filing
Unpaid Balance
of Assessment
(f)
3172.80
3007.78
6180.58
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
the 23rd day of August 2002
Signature...-%, / "/~ '~_ [ Title
(" V/-. /// ~.~/X~--~--~..._,~......//'f. I Acs 12-00-0000
for P~-~~' /- - // I (800) 829-7650
(NOTE: Certificate of officer authorized by law to ta(l('e acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form &68(Y)(c) (Rev. 10-00)
Part I - Kept By Recording Office CAT. NO 60025X