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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 109283814
As provided by section 6321, 6322, and 6323 of the Internal Revenue L/_ 7LI- raTL
Code, we are giving a notice that taxes (including interest and penalties) w?
have been assessed against the following-named taxpayer. We have made = o
a demand for payment of this liability, but it remains unpaid. Therefore, mW ;
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
rr-. N '
additional penalties, interest, and costs that may accrue. QCT
Name of Taxpayer MICHELE M SMITH .
PLATINUM AUTO SPA
Residence 1968 SPRING RD
CARLISLE, PA 17013
E
RTANT RELEASE INFORMATION: For each assessment listed below,
notice of the lien is refiled by the date given in column (e), this notice shall,day following such date, operate as a certificate of release as defined
3325(a). n a ��3
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)
941 12/31/2013 45-2690345 05/19/2014 06/18/2024 4087 . 97
Place of Filing
Prothonotary
Cumberland County Total $ 4087 . 97
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the lith day of July 2014
SignatureTitle
REVENUE OFFICER 22-06-2614
for LINDSEY O BOWLIN (717) 777-9623
(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