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Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
(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 948879513
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
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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 m a
property belonging to this taxpayer for the amount of these taxes, and '
additional penalties, interest, and costs that may accrue. rte- r�-: F
D 0 C)
Name of Taxpayer MICHAEL F BARNES r--
Residence 2815 FAIRVIEW RD"
�
CAMP HILL, PA 17011 -1623 s-
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 L
following such date, operate as a certificate of release as defined �� Pv/ -
in IRC 6325(a). * 2 � I
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
6672 12/31/2002 XXX -XX -9056 10/11/2004 11/10/2014 39420.03
6672 03/31/2003 XXX -XX -9056. 10/11/2004 11/10/2014 81609.63
6672 09/30/2003 XXX -XX -9056 10/11/2004 11/10/2014 44638.67
6672 12/31/2003 XXX -XX -9056 10/11/2004 11/10/2014 65860.63
6672 03/31/2004 XXX -XX -9056 08/06/2007 09/05/2017 32223.72
6672 12/31/2004 XXX -XX -9056 08/06/2007 09/05/2017 12963.20
6672 06./30/2005 XXX -XX -9056 08/06/2007 09/05/2017 12725.82
Place of Filing
Prothonotary
Cumberland County Total $ 289441.70
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)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2 -2004)
CAT. NO 60025X