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Form 668 (Y)(c)
(Rev. February 2004)
11883
Department of the Treasury - Internal Revenue Service
Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA 42
Lien Unit Phone: (800) 913-6050 827274711
As provided by section 6321, 6322, and 6323 of the Internal Revenue _
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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 c
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there is a lien in favor of the United States on all property and rights to
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property belonging to this taxpayer for the amount of these taxes, and 2zi c° mar=
additional penalties, interest, and costs that may accrue. cCn
Name of Taxpayer JAMON D REID CQ z
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Residence
231 N BEDFORD ST -
CARLISLE, PA 17013 t c?
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,
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on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). 12,?- X_ -2
Kind of Tax Tax Period
Ending
Identifying Number Date of
Assessment Last Dayy for
Refiling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2008 XXX-XX-3578 06/27/2011 07/27/2021 8049.78
1040 12/31/2009 XXX-XX-3578 03/21/2011 04/20/2021 5170.17
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ?$ 13219.95
This notice was prepared and signed at DETROIT, MI
the 07th day of November 2011.
, on this,
Signature Title
e4ft C` ACS SBSE 22-00-0001
for FRED BANKS _44 (800) 829-3903
(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 Form 668(Y)(c) (Rev. 2-2004)
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