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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 846388012
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 r? ,
property belonging to this taxpayer for the amount of these taxes, and i
additional penalties, interest, and costs that may accrue. -
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Name of Taxpayer STEPHEN C SHILEY z
Residence 410 S HIGH ST - -m
MECHANICSBURG, PA 17055-6430
NT RELEASE INFORMATION: For each assessment listed below
,
e of the lien is refiled by the date given in column (e), this notice shall,
F Y
following such date, operate as a certificate of release as defined
IRC
5(a). ?1)
Kind of Tax Tax Period
Ending
Identifying Number Date o f
Assessment Last Da)r for
Refilling Unpaid Balance
of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2006 XXX-XX-1435 08/30/2010 09/29/2020 34171.70
1040 12/31/2007 XXX-XX-1435 08/30/2010 09/29/2020 3977.53
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total 1 $ 38149.23
This notice was prepared and signed at DETROIT, MI
the 31st day of January 2012
, on this,
Signature Title
0;0ft? ACS SBSE 22-00-0001
for FRED BANKS (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)
CAT, NO 60025X