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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
Notice of Federal Tax Lien
(Rev. February 2004)
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 884546112
As provided by section 6321, 6322, and 6323 of the Internal Revenue
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 Ilen in favor of the United States on all property and rights to ti
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property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. =M
Name of Taxpayer JOHN F JR GEORGIADIS
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Residence 13 ASHBURG DR
MECHANICSBURG, PA 17050-8205 5
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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, a
on the day following such date, operate as a certificate of release as defined J?
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in IRC 6325(a). ??C'1r o2 7b
Tax Period Date of Last Day for Unpaid Ba nce
Kind of Tax Ending Identifying Number Assessment Ref iling of Assess nt
1040 12/31/2004 XXX-XX-7798 12/20/2011 01/19/2022 11 12.59
1040 12/31/2007 XXX-XX-7798 12/20/2011 01/19/2022 26 07.73
Place of Filing
Prothonotary
Cumberland County Total $ 37 20.32
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 27th day of July 2012
Signature ACS SBSE 22-00-0001
for P.A. BELTON (800) 829-3903
(NCVM*. 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)
Part 1 -Kept By Recording Office Form 668(Y)(c) (ev. 2-2004)
CAT. O 60025X