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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 BUSINESSfSELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 878338112
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As provided by section 6321, 6322, and 632
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 '
property belonging to this taxpayer for the amount of these taxes, and ?3
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additional penalties, interest, and costs that may accrue. X
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Name of Taxpayer MICHAEL A SHERRIFF r 1 C:
Residence 436 MOUNT ROCK RD 1 C-)
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NEWVILLE, PA 17241-9576
NT RELEASE INFORMATION: For each assessment listed below,
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
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5(a). ? _7(_y
Tax Period Date of Last Day for Unpaid Bal nce
Kind of Tax Ending Identifying Number Assessment Refling of Assess nt
(a) (b) (c) (d) (e) (f)
941 03/31/2010 25-18151:32 06/21/2010 07/21/2020 3 09.18
941 06/30/2010 25-18151:32 09/13/2010 10/13/2020 3 03.53
941 12/31/2010 25-18151:32 03/26/2012 04/25/2022 1 91.51
941 03/31/2011 25-18151:32 03/26/2012 04/25/2022 7 39.43
941 06/30/2011. 25-18151:32 03/26/2012 04/25/2022 9 40.74
941 09/30/2011. 25-18151:32 03/26/2012 04/25/2022 11796.17
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Place of Filing
Prothonotary
Cumberland County Total $ 34430.56
Carlisle, PA 1701.3
This notice was prepared and signed at DETROIT, MI on this,
the 28th day of June 2012
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Signature ATitle
CS SBSE 22-010-0001
for P.A. BELTON (800) 829-3903
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal T x lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409)
Form 668( Ne??.2 20041
Part I - Kept By Recording Office CAT.
CAT. NO 60025X