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499
Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. October 2000)
Area: Seiial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 no. o/-/Ci "IS t"TI-
Lien Unit Phone: (800) 829-3903 230172313
As provided by section 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 following-named taxpayer. We have made
a demand for payment of this liability, but it remains unpaid. Therefore,
there is a lien in favor of the United States on all property and rights to (") CJ 0
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property belonging to this taxpayer for the amount of these taxes, and ?:. > -~!
additional penalties, interest, and costs that may. accrue. -0 IT) -0 --
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Name of Taxpayer ALAN C & NORA I SHEARER zc I 11
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Residence 11 PARK ST c..,) Z-SrTi
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MT HOLLY SPGS, PA 17065-1433 Z - ):~
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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 'fa.. PJ... j rl9.uV
in IRe 6325(a).
Tax Period Date of Last Dal. for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi mg of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1997 210-40-3673 06/01/1998 07/01/2008 3234.67
1040 12/31/1999 210-40-3673 07/10/2000 08/09/2010 4113.43
Place of Filing
Prothonotary Total $
Cumberland County 7348.10
Carlisle, PA 17013
This notice was prepared and signed at
PITTSBURGH, PA
, on this,
14th day of March
2001
the
Signature
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Title
ACS
23-01-0008
for L G DOWD (800) 829-3903
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien
Rev. Rul. 71-466. 1971 - 2 C.B. 409)
Part 1 - Kept By Recording Office
Form 668(Y)(c) (Rev. 10-001
CAT. NO 60025X
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