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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
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a: Serial Number For Optional Use by Recording Office
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SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 840678212
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As provided by section 6321, 6322, and 6323 of the ?
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 -vim
property belonging to this taxpayer for the amount of these taxes, and rn vo t _. m
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additional penalties, interest, and costs that may accrue. == =r
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Name of Taxpayer DUANE L SHOPE -<
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C.)
Residence 52 SCARSDALE DR _
CAMP HILL, PA 17011-7938
NT RELEASE INFORMATION: For each assessment listed below, ?? ?(
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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
5(a).
IRC
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2006 XXX-XX-3591 03/29/2010 04/28/2020 38886.42
1040 12/31/2007 XXX-XX-3591 07/26/2010 08/25/2020 56730.97
1040 12/31/2008 XXX-XX-3591 03/07/2011 04/06/2021 27559.99
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 123177.38
This notice was prepared and signed at
the 09th day of January
DETROIT, MI
2012
, on this,
Signature REVENUE OFFICER 22-06-1418
for JAKOB PEDERSEN (717) 777-9621
(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 668(Y)(c) (Rev. 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X