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12-6714
11883 Form 668 (Y)(c) (Rev. February 2004) Department of the Treasury -Internal Revenue Service Notice of Federal Tax Lien Area: Serial Number WAGE & INVESTMENT AREA #1 Lien Unit Phone: (800) 829-7650 902598512 As provided by section 6321, 6322, and 6323 of the Internal Revenue Code, we are giving a notice that taxes (including h>Iterest and penalties) have been assessed against the following-named taxpayer. We have made a demand for payment ~ this liability, but it remains unpaid. Therefore, there is a Een in favor of the United States on all property and rights to property bebngh,<g to this taxpayer for the amount of these taxes, and additional penalties, interest, and costs that may accrue. e of taxpayer Residence 458 N WEST ST CARLISLE, PA 17013-1962 ~ c ~ ~ ~- -~; -,~~ ~ --f ~ ~ ~ ~~ ~~ Z:© a ~ ~ --f 1V ~" -C rn ^=' IMPORTANT RELEASE Ii~IFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column (e), this notice shall, ,r~, d /~ `v , j on the day following such date, operate as a certificate of release as defined o~~'~ `''/ Or in IRC 6325(a). ~~ oL ~Z(~Oy" Tax Period Date of Last ppa~yy for Unpaid Balance Kind of Tax Ending Identifying Number Assessment RefiRng of Assessment (a) (b) (c) (d) (e) (f) 1040 12/31/2004 XXX-XX-0848 05/30/2005 06/29/2015 2355.31 1040 12/31/2005 XXX-XX-0848 05/29/2006 06/28/2016 1113.62 1040 12/31/2006 XXX-XX-0848 07/05/2010 08/04/2020 1750.99 1040 12/31/2007 XXX-XX-0848 05/31/2010 06/30/2020 1186.39 1040 12/31/2008 XXX-XX-0848 07/13/2009 08/12/2019 857.44 1040 12/31/2009 XXX-XX-0848 06/14/2010 07/14/2020 1623.50 1040 12/31/2010 XXX-XX-0848 05/30/2011 06/29/2021 2447.34 Place of Filing Prothonotary Cumberland County Carlisle, PA 17013 For Use by Recording Office Total ~$ 113 3 4. 5 9 This notice was prepared and signed at DETROIT, MI the 26th day of October 2012 on this, Signature Title ~ ~-~ ACS W&I 11-00-0000 for DEBRA K. HURST (800) 829-7650 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rav_ Rul 71-dRR 1A71 - ~ (.R ana~ Form 668(Y)(c) (Rev. 2-20041 Part 1 -Kept sY Rewrding Office CAT. NO 60025X