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11883
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 889149012
As provided by section 6321, 6322, and 6323 of the Internal Revenue f
a ~ ~ a -w~ ~
LJ
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 ~ • r
additional penalties, interest, and costs that may accrue. 3
Name of Taxpayer MATTHEW E MYERS ~ ~ ~ • f--
~ _ ~
Residence 478 SAMPLE BRIDGE RD ~°t='' 3,. ~
ENOLA , PA 17 0 2 5 -10 2 5 x ~
~ CQ t
IMPORTANT RELEASE INFORMATION: For each assessment listed below, ~ ;z~;
unless notice of the lien is refiled by the date given in column (e), this notice shall, ' , - -
on the day following such date, operate as a certificate of release as defined S ~ ~
Tax Period Date of Last Da)r for Unpaid Bal nce
Kind of Tax Ending Identifying Number Assessment Refilmg of Assessm nt
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX-XX-4111 02/27/2012 03/29/2022 57...07.18
1040 12/31/2007 XXX-XX-4111 02/27/2012 03/29/2022 55125.00
1040 12/31/2008 XXX-XX-4111 02/20/2012 03/22/2022 38110.57
1040 12/31/2009 XXX-XX-4111 11/15/2010 12/15/2020 48179.14
1040 12/31/2010 XXX-XX-4111 07/25/2011 08/24/2021 4426.64
Place of Filing
Prothonotary
Cumberland County Total $ 24348.53
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI _ ` `
on this,
the 21st day of August 2012
Signature Title
~ \C-~-~ ACS SBSE 22-00-0001
for P.A. BECTON (800) 829-390:3
(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tabs lien
Rev. Rul. 71-466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-20041
Part 1 -Kept By Recording Office CAT. NO 60025X