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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 962258213
As provided by section 6321, 6322, and 6323 of the Internal Revenue 13 ~,10
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 " us
additional penalties, interest, and costs that may accrue. :
Name of Taxpayer THOMAS G HAMMOND JR .,� 1-71 �"
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Residence PO BOX 333 .-- c C
NEWBURG, PA 17240 -0333 -!-
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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, /.SV pp( L� d 7'
on the day following such date, operate as a certificate of release as defined `
in IRC 6325(a).
Tax Period Date of Last Da yy for s � 7 Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Reriliing of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2012 XXX -XX -6655 04/29/2013 05/29/2023 30595.05
Place of Filing
Prothonotary
Cumberland County Total $ 30595.05
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 19th day of September 2013
Signature Title
C —�-� 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