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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 1 1 963947613
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
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
additional penalties, interest, and costs that may accrue. c
IITI
Name of Taxpayer CHRISTOPHER M GILBERT 7u —+ -
r
Residence 2435 DEWEY LN rs CD
ENOLA, PA 17025 -1360 7:Zr,
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, 21 _S'V
on the day following such date, operate as a certificate of release as defined �� 2
in IRC 6325(a). �,�,* �2 � ?1-1 13
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
6672 03/31/2009 XXX -XX -3946 11/15/2010 12/15/2020 26275.94
6672 06/30/2009 XXX -XX -3946 11/15/2010 12/15/2020 25034.00
6672 09/30/2009 XXX -XX -3946 11/15/2010 12/15/2020 22680.40
6672 12/31/2009 XXX -XX -3946 13/15/2010 12/15/2020 10520.64
I
Place of Filing
Prothonotary
Cumberland County Total $ 84510.98
Carlisle, PA 17013
This notice was re ared and signed at DETROIT, MI
p p 9 , on this,
the 01st day of October 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) Form 668(Y)(c) (Rev. 2 -2004)
Part 1 -Kept By Recording Office CAT. NO 60025X