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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) 913-6050 999501314
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, M w F n
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there is a lien in favor of the United States on all property and rights to �� --� -0
property belonging to this taxpayer for the amount of these taxes, and
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additional penalties, interest, and costs that may accrue. ¢= '
Name of Taxpayer AVINASH D CHATURVEDI c =
C7 ` r
Residence 109 NOVEMBER DR APT 4 "`
CAMP HILL, PA 17011-0000
E
TANT RELEASE INFORMATION: For each assessment listed below,
otice of the lien is refiled by the date given in column (e), this notice shall,ay following such date, operate as a certificate of release as defined
325(a). 1 266,0 7�
Tax Period Date of Last Da for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a). (b) (c) (d) (e) (f)
1040 12/31/2011 XXX-XX-1233 02/10/2014 03/11/2024 36844 . 85
Place of Filing
Prothonotary
Cumberland County Total $ 36844 . 85
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 12th day of May 2014.
Signature Title
\C-�-�G REVENUE OFFICER 22-01-2016
for M MATTHEWS (973) 921-4313
(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( CAT (Rev. 2-2004)
CAT. NO 60025X