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Department of the Treasury - Internal Revenue Service
Form 668 ( Notice of Federal Tax Lien
(Rev. February 2 2004) 0041 ?L. 09_ F.;? YF F-*L
A Serial Number For Optional Use by Recording Office
rea:
WAGE & INVESTMENT AREA #1 ,?j & lij, 1W
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Lien Unit Phone: (800) 829-7650 599676109 -
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As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck. Y 512-
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made 3 y A,51
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. c? ,
Name of Taxpayer JOHN CHRISTOPHER SMITH -?
W ??1.
Residence 626 PARK RIDGE DR - CZ)
MECHANICSBURG, PA 17055-5871
PORTANT RELEASE INFORMATION: For each assessment listed below, j
ss notice of the lien is refiled by the date given in column (e), this notice shall,
F
the day following such date, operate as a certificate of release as defined
o
in
RC 6325(a ).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2004 XXX-XX-3395 03/09/2009 04/08/2019 43326.60
1040 12/31/2006 XXX-XX-3395 03/09/2009 04/08/2019 79633.11
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 122959.71
This notice was prepared and signed at DETROIT, MI
the 18th day of November 2009
, on this,
Signature A Title
ACS 11-00-0000
for DEBRA K. HURST (800) 829-7650
( : 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 I - Kept By Recording Office C-AT. NO 60025X