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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien /h~ ~n
(Rev. February 2004) I V - 3 do8
Serial Number For Optional Use by Recording Office
Area:
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650
653010110 ~~Q.00 pp p~,~
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As provided by section 632 t, 6322, and 6323 of the Internal Revenue # a
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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 ~
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d
additional penalties, interest, and costs that may accrue. ~' E-~-'
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Name of Taxpayer ALYS IA S S IMPSON ~' `; `
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Residence 13 3 W LOCUST ST APT C7 =y;, ~ ~-~ ~ ~ y
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MECHANICSBURG, PA 17055-6354 ~
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 Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (~
1040 12/31/2003 XXX-XX-2258 02/23/2009 03/25/2019 7333.29
1040 12/31/2006 XXX-XX-2258 02/23/2009 03/25/2019 2732.48
1040 12/31/2008 XXX-XX-2258 06/22/2009 07/22/2019 1206.64
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
DETROIT, MI
This notice was prepared and signed at
the 06th day of May
Total ~$ 11272.41
on this,
2010
Signature N ;
for DEBRA K. HURST
Title
ACS
(800) 829-7650
11-00-0000
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essennai to the vanaicy v. ,~~.,~o ~~ ~ ~~~~ ~• ~ ~~ ••~•
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