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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien n
(Rev. February 2004) /W. ,OG
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Serial Number For Optional Use by Recording Office
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #2
581549509
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Lien Unit Phone: (800) 913-6050 d
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As provided by section 6321, 6322, and 6323 of the Internal Revenue ?3 r
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made 3 b 9 a. 9
a demand for payment of this liability, but it remains unpaid. Therefore, r.?
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 Z
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additional penalties, Interest, and costs that may accrue.
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Name of Taxpayer NANCY MARRIERO "
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Residence
PO BOX 839
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MECHANICSBURG, PA 17055-8839
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 Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refing of Assessment
(a) (b) (c) (d) (e M
940 12/31/2001 25-1895027 03/18/2002 04/17/2012 113.30
940 12/31/2002 25-1895027 04/07/2003 05/07/2013 58.21
941 12/31/2001 25-1895027 04/08/2002 05/08/2012 1452.28
941 03/31/2002 25-1895027 07/15/2002 08/14/2012 397.22
941 12/31/2002 25-1895027 03/31/2003 04/30/2013 190.85
941 06/30/2003 25-1895027 10/06/2003 11/05/2013 134.28
941 09/30/2003 25-1895027 01/05/2004 02/04/2014 41.54
941 12/31/2003 25-1895027 04/05/2004 05/05/2014 180.34
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $
This notice was prepared and signed at DETROIT, MI
the 15th day of September 2009
2568.02
, on this,
Signature -?./ A `'Y?? Title
REVENUE OFFICER 22-06-1461
for JACOB SANDRICK (570) 322-5611
(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 66SM(e) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X