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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c)
IRev. February 2004) Notice of Federal Tax Lien
Area• Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2 ~ n ;~~~
Lien Unit Phone: (800) 829-3903 359504707 Y,L, ~J~
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As provided by section 6321, 6322, and 6323 of the Internal Revenue L
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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
property belonging to this taxpayer for the amount of these taxes, and ,
additional penalties, interest, and costs that may accrue.
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Name of Taxpayer SCOTT A MACAK T`~~
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Residence 7 0 7 BRENTON ST _ ' `-,''
SHIPPENSBURG, PA 17257-2115 ~ -.'
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IMPORTANT RELEASE INFORMATION: For each assessment listed below, .
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unless notice of the lien is refiled by the date given in column le), this notice shall, ~
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2001 XXX-XX-9106 01/08/2007 02/07/2017 17125.50
1040 12/31/2002 XXX-XX-9106 01/08/2007 02/07/2017 18078.80
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 35204.30
This notice was prepared and signed at
the 19th day of April
DETROIT, MI
2007
on this,
Signature ~ !~ ~~y~~,QQ ACS 22-00-0008
for REGINA OWENS (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) Form 668(ln(c) IRev. 2-2004)
Part 1 -Kept By Recording Oliice CAT. NO 60025X