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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 969543713
As provided by section 6321, 6322, and 6323 of the Internal Revenue /-3
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 JEFFREY V SLADE 70 ro
2 r—
o,
Residence 244 S ENOLA DR C-5
ENOLA, PA 17025 - 2812:
ro
IMP 7hsed NT RELEASE INFORMATION For each assessment listed below, y "'
unlee of the lien is refiled by the date given in column (e), this notice shall,
on tfollowing such date, operate as a certificate of release as defined in I5(a). Ae,�
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2010 XXX -XX -4862 07/01/2013 07/31/2023 2980.02
1040 12/31/2011 XXX -XX -4862 06/24/2013 07/24/2023 1990.01
1040 12/31/2012 XXX -XX -4862 09/02/2013 10/02/2023 1899.94
Place of Filing
Prothonotary
Cumberland County Total $ 6869.97
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 15th day of November 2013
Signature Title
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)
Part t - Kept By Recording Office Form 666( CAT (Rev. 2-200
CAT. NO 60025X X