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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) 913 -6050 937518913
As provided by section 6321, 6322, and 6323 of the Internal Revenue 13 "a<oa FrL
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 fl `
property belonging to this taxpayer for the amount of these taxes, and ZZ -
additional penalties, interest, and costs that may accrue. r- m ;
Name of Taxpayer ZACHARY PLETCHER - -t ,
Residence 156 CREEKSIDE DRr
ENOLA, PA 17025 - 2917'?-
F 7hed NT RELEASE INFORMATION For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall, a following such date, operate as a certificate of release as defined
5(a). PV� a !FO39 ,<--
Ta x Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2010 XXX -XX -3977 12/10/2012 01/09/2023 135308.60
Place of Filing
Prothonotary
Cumberland County Total $ 135308.60
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 03rd day of May 2013
Signature Title
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)
Part t - Kept By Recording Office Form 668( CAT (Rev. 025X )
CAT. NO 60025X