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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(c)
(Rev.February 2404) 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 998506814 �7,L
As provided by section 6321, 6322, and 6323 of the Internal Revenue /Iy
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-
additional penalties, interest, and costs that may accrue. Ca ^�
Name of Taxpayer RAFAEL D COLLADO � -ter U--
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Residence 975 HUMMEL AVE
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LEMOYNE, PA 17043-1738 ::°'j
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RTANT RELEASE INFORMATION: For each assessment listed below, -�►
notice of the lien is refiled by the date given in column (e), this notice shall, �f. �,� .GG
day following such date, operate as a certificate of release as defined
6325(a). , 3 1> 75-
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) I (d) (e) (f)
1040 12/31/2009 XXX-XX-1446 07/08/2013 08/07/2023 23170 .29
Place of Filing
Prothonotary
Cumberland County Total $ 23170.29
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 06th day of May 2014
Signature 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 I - Kept By Recording Office CAT. NO 60025X