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11883
Department of the Treasury - Internal Revenue Service
Form 668 M(c) Wn*iea of Fadtaral Tax Lien
(Rev. February 2004) - - - -- - -
Serial Number For Optional Use by Recording O ffice
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 880655412
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As provided by section 6321, 6322, and 6323 of the Internal Revenue J ??S?oZ "
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
additional penalties, interest, and costs that may accrue. z rr'
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Name of Taxpayer ALLEN J & FAITH GOURLEY
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Residence 1933 SHERIDAN RD _ f ?.
NEW BETHLEHEM, PA 16242-3853 r?
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IMPORTANT RELEASE INFORMATION: For each assessment listed bjhl
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umn (e), t
unless e of the lien is refiled by the date given in co _
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the following such date, operate as a certificate of release as de
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in IRC 5(a).
Tax Per iod Date of Last Day for Unpaid Bala nce
Kind of Tax Ending Identifying Number Assessment Refiling of Assessme nt
(a) (b) (c) (d) (e) M
1040 12/31/2009 XXX-XX-2439 11/15/2010 12/15/2020 6156 8.19
1040 12/31/2010 XXX-XX-2439 11/21/2011 12/21/2021 2900 1.62
Place of Filing
Prothonotary
Cumberland County Total $ 90575 09 . 81
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 11th day of July 2012
Signature REVENUE OFFICER 22-1 1-1918
for SAMUEL L. HUEY (724) 282-0545 x18000
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity or Nonce or reaerai x lien
Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Re . 2-2004)
Part 1 - Kept By Recording Office CAT. NO 60025X