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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
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 922683313
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,
h 1' f f the United States on all property and rights to
For Optional Use by Recording Office
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t ere is a yen m avor o
property belonging to this taxpayer for the amount of these taxes, and -~
additional penalties, interest, and costs that may accrue. ~-~ =' `~`'
Jame of Taxpayer D MCCAUSLIN & M TRIPPETT MCCAUSLI "r l ~"
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Residence PO BOX 647
NEW KINGSTOWN, PA 17072-0647
Tax Period Date of
Ending Identifying Number Assessment
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, ~~ S W /^~~ ~ ~ - j'
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). ~ ~ ~~ f~~~
Kind of Tax
(a)
1040
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
6814.25
Total ~ $ 6 814 .2 5
This notice was prepared and signed at
the 14th day of February
DETROIT, MI
2013
on this,
Signature ~~~ ACS SBSE 22-00-0001
for P.A. BECTON (800) 829-3903
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Last Dayy for unpaid Balance
Refiling of Assessment
12/31/2007 XXX-XX-0388 I06/02/2008I 07/02/2018
(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 -Kept sY Recording Of-ice Form 668(Y)(c) (Rev. 2-20041
CAT. NO 60025X