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Department of the Treasury -Internal Revenue Service
Form 668 (Y)(c) Notice of Federal Tax Lien
IRev. February 20041
Serial Number For Optional Use by Recording Office
Area:
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829-3903 922683413
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As provided by section 6321, 6322, and 6323 of the
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 rte'-=' °°°.r.,'t
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additional penalties, interest, and costs that may accrue. " ,
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Name of Taxpayer DONALD J MCCAUSLIN ~'1 .
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Residence p0 BOX 647 f "~
NEW KINGSTOWN, PA 17072-0647 ',
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column le-, this notice shall, ; ~J. S ~ ~~~/ '
on the day following such date, operate as a certificate of release as defined ~~++
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (i7
1040 12/31/2008 XXX-XX-0388 10/12/2009 11/11/2019 4566.28
1040 12/31/2009 XXX-XX-0388 02/07/2011 03/09/2021 8391.31
1040 12/31/2010 XXX-XX-0388 05/30/2011 06/29/2021 5594.05
Place of Filing
Prothonotary
Cumberland County
Carlisle, PA 17013
Total ~$ 18551.64
This notice was prepared and signed at _ DETROIT, MI
the 14th day of February 2 013
on this,
Signature Title
~~~C-~-~ 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 -Kept BY Rewrding Office Form 668(Y)(c) IRev. 2-2004)
CAT. NO 60025X