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Form 668 (Y)(c)
(Rev. February 2004)
Area:
WAGE & INVESTMENT AREA #2
lien Unit Phone: (800) 829-7650
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
For Optional Use by Recording Office
Serial Number 177542304
As provided by section 632t, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that Uxes (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 ali propeF~y and rights to
propefl7 belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and cosu that may accrue.
Name of Taxpayer GREGORY T CLOUSER
1107 HARRISBURG PIKE
CARLISLE, PA 17013-1618
Residence
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 Retiring of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/1996 186-56-3236 11/24/1997 12/24/2007 2913.01
1040 12/31/1997 186-56-3236 03/20/2000 04/19/2010 31687.53
1040 12/31/1998 186-56-3236 08/13/2001 09/12/2011 31957.18
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total $ 66557.72
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
the 16th day of June 2004
Signature -' z~.,& /? t~ t) I Title
V ) z{,~'~.~ . I.,(~ ,~/ 12-00-0000
for P S LANE 0) 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 6&8(Y)(c) (Rev. 2-2004)
Parr 1 - Kept By Recording Office CAT. NO 60025X