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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax. Lien
lRev. Fetrruary 20441
Serial Number For Optional Use by Recording Office
Area:
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650
726267810
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~~~
As provided by section 6321, 6322, and b323 of the Internal Revenue
Gode, 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 ai! property and rights to "~~ d
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property belonging to this taxpayer for the amount of these taxes, and ~~ ~ r?„~r
additional penalties, interest, and costs that may accrue, ~~ `~ ~""
~~ r ~~
Name of Taxpayer WILLIAM M SHEESLEY ~~ "`~ ~~
~' ~ ~-Y
Residence 3609 LISBURN RD ~~~ ~ ~~~
MECHANICSBURG PA 17055-6710 ~ "`
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IMPORTANT RELEASE INFORMATION: Far each assessment listed below,
unless notice of the lien is refiled by the date given in column (e-, this notice shall, a
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on the day following such date, operate as a certificate of release as defined ~~
in IRC 6325ta). o~ SoC f fJ
Tax Period Date of Last Dayy for Einpaid Balance
Kind of Tax Ending Identifying Number Assessment Refi[ing of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2002 XXX-XX-3988 04/03/2006 05/03/2016 2736.52
1040 12/31/2005 XXX-XX-3988 04/14/2008 05/14/2018 5234.63
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $
7971.15
This notice was prepared and signed at ~ DETROIT, MI
the 30th day of November 2010
on this,
Signature ~~~ Title
ACS 11-00-0000
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. 4491 Form. b68(Y)(c) (Rev. 2-2.004)
Part 1 -Kept gy RecorQing Office CAT. NO 600?_5x