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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
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829 -7650 970003813 GTL
As provided by section 6321, 6322, and 6323 of the Internal Revenue �3 7 X97
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, -n rn 7 Z c = -
there is a lien in favor of the United States on all property and rights to r . r
property belonging to this taxpayer for the amount of these taxes, and
additional penalties, interest, and costs that may accrue. fi "c..
Name of Taxpayer SUSAN P & WAYNE J MASON
CD
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3 4= co
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Residence 521 SANDPIPER LN
NEW CUMBERLND, PA 17070 -2864
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, �j)
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
Tax Period Date of Last Dayy for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2010 XXX -XX -4009 04/15/2013 05/15/2023 3635.41
1040 12/31/2011 XXX -XX -4009 04/15/2013 05/15/2023 3296.01
1040 12/31/2012 XXX -XX -4009 06/03/2013 07/03/2023 2861.05
Place of Filing
Prothonotary
Cumberland County Total $ 9792.47
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 20th 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) Form 668(Y)(c) (Rev. 2 -2004)
Part 1 -Kept By Recording Office CAT. NO 60025X