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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004) 9• 9y' Fri-
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S For Optional Use by Recording Office
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WAGE & INVESTMENT AREA #1
557079109
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Lien Unit Phone: (800) 829-7650
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck tj13D
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made ,? L 9 8 y
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.
Name of Taxpayer ERNEST R JOHNSON
C?
Residence 447 LEWISBERRY RD APT D
NEW CUMBRLAND, PA 17070 == ?r _
RELEASE INFORMATION: For each assessment listed below,
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,
the lien is refiled by the date given in column (e), this notice shal
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owing such date, operate as a certificate of release as defined
IRC6325(a)).
Tax Period Date of Last Day for
filli
R Unpaid Balance
of Assessment
Kind of Tax Ending Identifying Number Assessment ng
e
(a) (b) (c) (d) (e) M
1040 12/31/2007 XXX-XX-4660 11/24/2008 12/24/2018 1614.01
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
DETROIT, MI
This notice was prepared and signed at
the 16th day of June
Total 1$ 1614.01
, on this,
2009
Title
Signature A A
11-00-0000
CS
for DEBRA K. HURST (800) 829-7650
(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(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X