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Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service
(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) 829 -3903 990663814
As provided by section 6321, 6322, and 6323 of the Internal Revenue A/ ' P 's03 )r- - 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 c
1
additional penalties, interest, and costs that may accrue. :D °._
M :0 - r _ _
Name of Taxpayer DANIEL B ALLEN
C
Residence 30 WALNUT BOTTOM RD c
SHIPPENSBURG, PA 17257 -8219 ' s-3
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, 7 -
on the day following such date, operate as a certificate of release as defined ��' � P� ` �" ,
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 12/31/2005 XXX -XX -0987 08/08/2011 09/07/2021 6373.27
1040 12/31/2006 XXX -XX -0987 08/08/2011 09/07/2021 17335.52
1040 12/31/2007 XXX -XX -0987 08/08/2011 09/07/2021 16037.51
1040 12/31/2008 XXX -XX -0987 02/07/2011 03/09/2021 14280.44
1040 12/31/2011 XXX -XX -0987 05/21/2012 06/20/2022 457.35
Place of Filing
Prothonotary
Cumberland County Total $ 54484.09
Carlisle, PA 17.013
.This notice was prepared and signed at DETROIT, MI , on this,
the 21st day of March 2014
Signature Title
ACS SBSE 22 -00 -0001
for P.A. BELTON (800) 829 -3903
(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