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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) 913-6050 880966112
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties) v
have been assessed against the following-named taxpayer. We have made r-41
a demand for payment of this liability, but it remains unpaid. Therefore, ?'? G
there is a lien in favor of the United States on all property and rights to N :
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. 'tee 1,
Name of Taxpayer MYRON & SHARRON GOLDEN ?_ .
Residence 6 LYNCHBURG CT
MECHANICSBURG, PA 17050-1748
IMPORTANT RELEASE INFORMATION: For each assessment listed below
,
unless notice of the lien is refiled by the date given in column (e), this notice shall,
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,
-
on the day following such date, operate as a certificate of release as defined
in IRC 6325(x). 4y* a7
Tax Period Date of Last Day for Unpaid Bal ance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessm ent
(a) (b) (c) (d) (e) (f)
1040 12/31/2007 XXX-XX-6028 11/03/2008 12/03/2018
1040 12/31/2007 XXX-XX-6028 05/17/2012 06/16/2022 1932 18.38
1040 12/31/2008 XXX-XX-6028 11/16/2009 12/16/2019
1040 12/31/2008 XXX-XX-6028 05/17/2012 06/16/2022 173 22.70
Place of Filing
Prothonotary
Cumberland County Total $ 3670 1.08
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 12th day of July 2012
Signature Title
REVENUE OFFICER 22-0 6-1418
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 Ta < 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 30025X