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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
Notice of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050
658181210
As provided by section 6321, 6322, and 6323 of the Internal Revenue g14. UCH %1L
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the following-named taxpayer. We have made ??- YD3.'t3
a demand for payment of this liability, but it remains unpaid. Therefore, Z ?s9
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there is a lien in favor of the United States on all property and rights to e
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property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.
Name of Taxpayer JAMES G JOHNSON
Residence 36 CAVALRY RD
CARLISLE, PA 17013-1601
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
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following such date, operate as a certificate of release as defined
o
RC
i
n I 5(a).
Tax Period Date of Last Day for U npaid Balance
Kind of Tax Ending Identifying Number Assessment Refilli ng of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2008 XXX-XX-2874 12/21/2009 01/20/2020 1458.52
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Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1$ 1458.52
This notice was prepared and signed at DETROIT, MI
the 20th day of May 2010
, on this,
Signature ?Y 1?1c? •`1Q Title
REVENUE OFFICER 22-06-1407
for SEAN DUNLEAVY (717) 777-9626
(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)
Part 1 - Kept By Recording Office CAT. 668( (Rev. 2-2004)
CAT. NO 60025X
X