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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
(Rev. February 20041
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 911111112
As provided by section 6321, 6322, and 6323 of the Internal Revenue ~ `~ ~~/ ` ~TG
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, _~ riv __.
there is a lien in favor of the United States on all property and rights to n ~? ~ =
property belonging to this taxpayer for the amount of these taxes, and -~-..-t__, e-~ _
additional penalties, interest, and costs that may accrue. "'~'r - _
_.~ . ~,
Name of Taxpayer RONALD M CRAWFORD `-- ~~~~~ _
~.
rY,.
~-,. -.
_.:> _ __
Residence 9014 DEERFIELD CMNS
SHIPPENSBURG, PA 17257-8551 "`''
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, ~r S~ZI ~~„/, G--r - T
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). ~~ ~ ~ y~~L'~
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2011 XXX-XX-3615 11/19/2012 12/19/2022 8256.55
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~ $ 8256.55
This notice was prepared and signed at
DETROIT, MI
the 11th day of December 2012
on this,
Signature Title
~\~~C..ts~~ REVENUE OFFICER 22 - 06 -1418
for JAKOB PEDERSEN (717) 777-9621
(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) Form 668(Y)(c) (Rev. 2-2004)
Part 1 -Kept By Recording Office CAT. NO 60025X