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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 964996713 _ L
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.
Name of Taxpayer GREGORY A FILAK
' W
Residence
143 OAK FLAT RD y> Z t
NEWVILLE, PA 17241 -9467
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).
Tax Period Date of Last Da yy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2008 XXX -XX -9221 12/26/2011 01/25/2022 3355.29
1040 12/31/2009 XXX -XX -9221 07/02/2012 08/01/2022 4719.59
1040 12/31/2011 XXX -XX -9221 08/26/2013 09/25/2023 4994.55
Place of Filing
Prothonotary
Cumberland County Total $ 13069.43
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 22nd day of October 2013
Signature Title
REVENUE OFFICER 22 -06 -2617
for J. MACDONALD (304) 263 -7625
(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