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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
SMALL BUSINESS /SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913 -6050 965239513
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, r
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 1 , --
additional penalties, interest, and costs that may accrue.
Name of Taxpayer RILEY LIVINGSTON
CD
3W C)
Residence 1397 CREEK RD APT D = U r ,.
e
2 = ,
BOILING SPRGS, PA 17007 - 9657
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
C:2/1 � `
in IRC 6325(a). hi -r7
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)
1040 12/31/2001 XXX -XX -6664 08/07/2006 09/06/2016 31379.12
1040 12/31/2002 XXX -XX -6664 08/07/2006 09/06/2016 30607.78
1040 12/31/2003 XXX -XX -6664 03/26/2007 04/25/2017 20584.25
1040 12/31/2004 XXX -XX -6664 07/23/2007 08/22/2017 24669.78
Place of Filing
Prothonotary
Cumberland County Total $ 107240.93
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 23rd 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)
Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 2 - 2004)
CAT. NO 60025X