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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 #5
Lien Unit Phone: (800) 913-6050 884479812
al Revenue
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As provided by section 6321, 6322, an
Code, we are giving a notice that taxes (including interest and penalties)
have been assessed against the fogowing-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 rte, -
additknul penalties, Interest, and costs that may accrue.
Name of Taxpayer GENE & MARIAM GREEN 'S
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Residence PO BOX 32 ''` 3
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WALNUT BOTTOM, PA 17266
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NT RELEASE INFORMATION: For each assessment listed below,
this notice shall,
the date given in column (e)
n is refiled b
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following such date, operate as a certificate of release as defined
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5(a).
IRC
Tax Period Date of Last Day for
fi Unpaid Ba nce
Kind of Tax Ending Identifying Number Assessment Re
ling of Assessm ent
(a) b) (c) (d) e
1040 12/31/2006 XXX-XX-8262 07/07/2008 08/06/2018 59 22.93
1040 12/31/2007 XXX-XX-8262 11/09/2009 12/09/2019 279 13.11
1040 12/31/2008 XXX-XX-8262 06/21/2010 07/21/2020 109 80.41
1040 12/31/2009 XXX-XX-8262 12/05/2011 01/04/2022 138 35.56
1040 12/31/2010 XXX-XX-8262 10/24/2011 11/23/2021 74 37.59
Place of Filing
Prothonotary
Cumberland County Total $ 660 9.60
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 26th day of July 2012
,
Signature
`
` ACS SBSE 25-00 -0008
ELTON
for P.A. B (800) 829-3903
(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 Recordle8 Office CAT. NO 0025X