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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev. February 2004) Notice of Federal Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS /SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 829 -3903 934738013
As provided by section 6321, 6322, and 6323 of the Internal Revenue 13— �3� -
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 w
--
additional penalties, interest, and costs that may accrue. zM c MF=
Name of Taxpayer LYDIA M VANDYNE fP0 �
CM C' t
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Residence " -°-
Z0 W LOCUST ST zC:
ENOLA, PA 17025 -3026 ry £rte
Fionl 7day NT RELEASE INFORMATION For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall, �� �(, T'
following such date, operate as a certificate of release as defined f'
5(a). c ';71d
Tax Period Date of Last Da for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f7
1040 12/31/2008 XXX -XX -2160 12/05/2011 01/04/2022 34344.61
1040 12/31/2009 XXX -XX -2160 10/08/2012 11/07/2022 40810.76
Place of Filing
Prothonotary
Cumberland County Total $ 75155.37
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 19th day of April 2013
Signature Title
ACS SBSE 22 -00 -0001
for P.A. BELTON (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)
AT
Part i - Kept By Recording Office Form 668( C (Rev. 2 -2004►
CAT. NO 60025X