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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 O ptional Use by Recording Office
SMALL BUSINESS /SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913 -6050 976292013
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
property belonging to this taxpayer for the amount of these taxes, and
w�
additional penalties, interest, and costs that may accrue. -�-
Name of Taxpayer THEODORE W ZEIDERS
-[> 1t
Residence PO
MEC PA 17055 -0657.
:n C.- �` c
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 1P S�
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) M
1040 12/31/2007 XXX -XX -1829 03/30/2009 04/29/2019 1110.33
1040 12/31/2009 XXX -XX -1829 08/02/2010 09/01/2020 3026.44
1040 12/31/2010 XXX -XX -1829 11/21/2011 12/21/2021 842.05
Place of Filing
Prothonotary
Cumberland County Total $ 4978.82
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 31st day of December , 2013
Signature �� REVENUE OFFICER 22-06-1413
for LINDSEY O BOWLIN (717) 777 -9623
(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 t - Kept By Recording Office CAT. NO 60025X