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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 2004)
Serial Number For Optional Use by Recording Office
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 85029571.2
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, -Q3 rV
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 -" 0m
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additional penalties, interest, and costs that may accrue.
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Name of Taxpayer JOY M SHIELDS
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Residence 308 E MAIN ST
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MECHANICSBURG, PA 17055-6517 L
RTANT RELEASE INFORMATION: For each assessment listed below.
notice of the lien is refiled by the date given in column (e), this notice shall,
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day following such date, operate as a certificate of release as defined
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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 12/31/2005 XXX-XX-0735 03/07/2011 04/06/2021 17096.47
1040 12/31/2007 XXX-XX-0735 03/07/2011 04/06/2021 11446.47
1040 12/31/2008 XXX-XX-0735 03/07/2011 04/06/2021 13971.41)
Place of Filing
Prothonotary
Cumberland County Total $
Carlisle, PA 17013
42514.43
This notice was prepared and signed at _ DETROIT, MI
the 17th day of February 2012
, on this,
Signature Title
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) Form 668(Y)(c) lRev. 2-2004)
Part 11 - Kept By Recording Office CAT. NO 60025X