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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice Of Feral 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 889793812
As provided by section 6321, 6322, and 6323 of the Internal Revenue ° S~~~l ~TL
Code, we are giving a notice that taxes (including interest and penakies)
have been assessed against the following-named taxpayer. We have made
a demand for payment of this liabilky, 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 penakies, interest, and costs that may accrue. a
Name of Taxpayer THOMAS J & VALINDA L OUSTER
cnf"
~Z ~ ~
Residence 20 CARLISLE RD APT 4 3a. ~
NEWVILLE, PA 17241-9745 _
a
IMPORTANT RELEASE 11~1FORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shall, o?~ d ~ ~
on the day following such date, operate as a certificate of release as defined
in IRO 6325(a). ~ a~~99
Tax Period Date of Last D for llnpiaid Balance
Kind of Tax Ending Identifying Number Assessment Refi~ng ~ Assessment
(a) b c) (d) (e) (f)
1040 12/31/2010 XXX-XX-6903 06/06/2011 07/06/2021 7084.73.
1040 12/31/2011 XXX-XX-6903 06/11/2012 07/11/2022 4253.61
Place of Filing
Prothonotary
Cumberland County Total $ 11338.34
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 23rd day of August 2012
Signature /';~-1~~ ACS SBSE 22-00-0001
for P.A. BECTON (800) 829-3903
(NOTE: 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 - K~?t By ftecordME Office Form 668(Y)(c) (Rev. 2-20041
CAT. NO 60025X