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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 968050413
As provided by section 6321, 6322, and 6323 of the Internal Revenue 1 3 4' 7 &-
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 rrn rn
additional penalties, interest, and costs that may accrue. �= --- -x;
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Name of Taxpayer ANN BARR�<T> CIS
RLB SERVICES r° - 2 = C'
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Residence 6838 WERTZVILLE RD ---F
ENOLA, PA 17025 -1032 �;rn
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 0 ` � ' L
in IRC 6325(a). 2-3
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)
940 12/31/2010 20- 4075486 10/07/2013 11/06/2023 5619.57
940 12/31/2012 20- 4075486 10/07/2013 11/06/2023 1511.18
941 03/31/2010 20- 4075486 10/07/2013 11/06/2023 5980.15
941 06/30/2010 20- 4075486 10/07/2013 11/06/2023 5880.89
941 09/30/2010 20- 4075486 10/07/2013 11/06/2023 5782.10
941 12/31/2010 20- 4075486 10/07/2013 11/06/2023 5687.71
941 03/31/2011 20- 4075486 10/07/2013 11/06/2023 5152.57
941 06/30/2011 20- 4075486 10/07/2013 11/06/2023 5062.85
941 09/30/2011 20- 4075486 10/07/2013 11/06/2023 4977.01
941 12/31/2011 20- 4075486 10/07/2013 11/06/2023 23589.14
941 03/31/2012 20- 4075486 10/07/2013 11/06/2023 1235.48
941 06/30/2012 20- 4075486 10/07/2013 11/06/2023 1213.27
941 09/30/2012 20- 4075486 10/07/2013 11/06/2023 1191.12
941 12/31/2012 20- 4075486 10/07/2013 11/06/2023 1169.03
Place of Filing
Prothonotary
Cumberland County Total $ 74052.07
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 07th day of November 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( CAT (Rev. 025X 1
CAT. NO 60025X