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Department of the Treasury - Internal Revenue Service
Form 668 (2)04)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 667875210
As provided by section 6321, 6322, and 6323 of the Internal Revenue
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
additional penalties, interest, and costs that may accrue.
Name of Taxpayer MICHAEL R BROWN
Residence 950 ORCHARD AVE LOT 1
CAMP HILL, PA 17011-6812
Prothonotary
Cumberland County
Carlisle, PA 17013
IMPORTANT RELEASE INFORMATION: For each assessment listed below, 19 00 ???%x U
unless notice of the lien is refiled by the date given in column (e), this notice shall, 9""0-4 on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). '72
Tax Period Date of Last Darr for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b (c d e (f)
1040 12/31/2001 XXX-XX-1465 03/23/2009 04/22/2019 4793.28
1040 12/31/2004 XXX-XX-1465 03/23/2009 04/22/2019 5522.77
Place of Filing
For Optional Use
Office
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Total 1 $ 10316.05
This notice was prepared and signed at DETROIT, MI
the 16th day of June 2010
, on this,
tle
11-00-0000
Signature A ACS
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 66SM(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X