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Department of the Treasury - Internal Revenue Service
Form 668 ( 2004)
(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 948879413
As provided by section 6321, 6322, and 6323 of the Internal Revenue 13 - F �L
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, w w�
there is a lien in favor of the United States. on all property and rights to r,
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue.' CD
,
Name of Taxpayer MICHAEL F & DANIELLE M BARNES -,
C=1
Residence'
2815 FAIRVIEW RD
CAMP HILL, PA 17011 -1623
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,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). 21933Lf4
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2005 XXX -XX -9056 05/28/2007 06/27/2017 502.20
Place of Filing
Prothonotary
Cumberland County Total $ 502.20
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 10th day of July 2013
Signature Title
REVENUE OFFICER 22 -03 -4033
for B. KREUTZER (412) 395 -6343
(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 t - Kept By Recording Office
CAT. NO 60025X