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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 113687114
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 v
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 - X-
0:3: r",
property belonging to this taxpayer for the amount of these taxes, and ., ;
additional penalties, interest, and costs that may accrue. r--
Name of Taxpayer MICHEAL E WALLACE
7�r3 CD c
Residence 72 W DOMFRET ST
CARLISLE, PA 17013-9610 `a
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, ,-2-/,.SV "g7w
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a). OV3 6RIV,
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 12/31/2010 XXX-XX-2990 04/28/2014 05/28/2024 3176 .34
Place of Filing
Prothonotary
Cumberland County Total $ 3176 .34
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI
on this,
the 07th day of August 2014
Signature /"-fir Title
REVENUE OFFICER 22-06-2624
for JAKOB A PEDERSEN (717) 777-9621
(NOTE: Certificate of officer authorized by 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(Y)(c) (Rev.2-2004)
CAT. NO 60025X