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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
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829 -7650 955669713 a
As provided by section 6321, 6322, and 6323 of the Internal Revenue 77
Code, we are giving a notice that taxes (including interest and penalties) c
have been assessed against the following -named taxpayer. We have made; • +c
C -
a demand for payment of this liability, but it remains unpaid. Therefore, . 3 ZZ - +
there is a lien in favor of the United States on all property and rights to zM C
property belonging to this taxpayer for the amount of these taxes, and =� G") Or". additional penalties, interest, and costs that may accrue. Cn r- o 6
Name of Taxpayer MICHAEL J PIETRAK x ,,. X --1
3 c-a ."�
5 c= ..,�• VIt
Residence 100 CENTER ST
ENOLA, PA 17025 -2602
F ORTANT RELEASE INFORMATION For each assessment listed below
s notice of the lien is refiled by the date given in column (e), this notice shall,
e day following such date, operate as a certificate of release as defined � S�'o� . 7�
6325(a). 9y�t1
Tax Period Date of Last Da for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2009 XXX -XX -4684 05/30/2011 06/29/2021 1512.61
1040 12/31/2010 XXX -XX -4684 05/30/2011 06/29/2021 19151.98
1040 12/31/2011 XXX -XX -4684 05/28/2012 06/27/2022 1446.98
1040 12/31/2012 XXX -XX -4684 06/03/2013 07/03/2023 814.27
Place of Filing
Prothonotary
Cumberland County Total $ 22925.84
Carlisle, PA 17013
This notice was prepared and signed at DETROI M I , on this,
the 15th day of August 2013
Signature Title
'_' ��Q_ 4 a -r' ACS W &I 11 -00 -0000
for DEANN BENDER (800) 829 -7650
(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 1 - Kept By Recording Office CAT. NO 60025X