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1872
Department of the Treasury - Internal Revenue Service
Form 668 (Y)( c) Notice of Federal Tax Lien
(Rev. February 2004) 17.A.I'S,(. y/ t::'rL
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #3 ~. /2(// ~ /'!. U?)
Lien Unit Phone: (412) 395-5265 210109705
As provided by section 6321, 6322, and 6323 of the Internal Revenue Ck-./ (fo:3
Code, we are giving a notice that taxes (Including interest and penalties)
have been assessed against the following-named taxpayer. We have made ~u f (~o'f 3> L-
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 rlghU to t',.)
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property belonging to this taxpayer for the amount of these taxes, and '":")
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additional penalties, interest, and costs that may accrue. -'1 --j
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Name of Taxpayer TIMOTHY R NORRIS I
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Residence PO BOX P ."-
NEW CUMBERLAND, PA 17070-0227 _.-
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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 63251al.
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refibng of Assessment
(a) (b) (c) (d) (e) (f)
6672 09/30/1996 227-94-0106 03/24/1997 04/23/2007 20968.60
6672 12/31/1999 227-94-0106 08/12/2002 09/11/2012 6266.95
6672 06/30/2000 227-94-0106 08/12/2002 09/11/2012 10605.97
6672 09/30/2000 227-94-0106 08/12/2002 09/11/2012 31031. 82
6672 12/31/2000 227-94-0106 08/12/2002 09/11/2012 31706.69
6672 03/31/2001 227-94-0106 08/12/2002 09/11/2012 26879.82
6672 06/30/2001 227-94-0106 08/12/2002 09/11/2012 33344.97
6672 06/30/2002 227-94-0106 12/09/2002 01/08/2013 32159.19
Place of Filing
Prothonotary
Cumberland County Total $ 192964.01
Carlisle, PA 17013
This notice was prepared and signed at
PHILADELPHIA, PA
, on this,
20th day of January
2005
the
for DAVID
Title
REVENUE OFFICER
(717) 221-3490
23-09-1442
Signature
(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(Y)(c) IRev. 2-2004)
CAT. NO 60025X