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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 982580614
As provided by section 6321, 6322, and 6323 of the Internal Revenue iy 7?1
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 JOHN G NASH M rri rn r
z3 ca - 0
Residence 1009 ALLEN ST
NEW CUMBERLND, PA 17070 -1526 c -
=C.7
70inl RTANT RELEASE INFORMATION For each assessment listed below, >�.
notice of the lien is refiled by the date given in column (e), this notice shall, �� ..4
day following such date, operate as a certificate of release as defined .P/
3325(a). 2
Tax Pe riod Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2010 XXX -XX -4606 01/13/2014 02/12/2024 431.11
1040 12/31/2011 XXX -XX -4606 01/06/2014 02/05/2024 1478.82
1040 12/31/2012 XXX -XX -4606 01/06/2014 02/05/2024 1442.36
Place of Filing
Prothonotary
Cumberland County Total $ 3352.29
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 03rd day of February 2014
Signature Title
REVENUE OFFICER 22 -06 -1418
for JAKOB PEDERSEN (717) 777 -9621
(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