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Department of the Treasury - Internal Revenue Service �ka
Form 668 (Y)(c) g9975
(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 974792913
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 MM c, t_ -r
property belonging to this taxpayer for the amount of these taxes, and P1 r ' `
additional penalties, interest, and costs that may accrue.
Y
Name of Taxpayer JEREMIAH J YOUNG rs r?
Residence 8 MOUNT ROCK RD
NEWVILLE, PA 17241 -9414
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 Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2011 XXX -XX -7976 11/18/2013 12/18/2023 103.36
1040 12/31/2012 XXX -XX -7976 11/18/2013 12/18/2023 27389.26
Place of Filing
Prothonotary
Cumberland County Total $ 27492.62
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 19th day of December 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