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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 118818514
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,
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
additional penalties, interest, and costs that may accrue. r r
Name of Taxpayer PROFESSIONAL PICC SUPPORT LLC
a Corporation -< ' --► C
Residence 2372 STILLHOUSE HOLLOW RD -�-�
E
SHIPPENSBURG, PA 17257-7903 ;
r\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,
on the day following such date, operate as a certificate of release as defined
in IRC 6325(a).
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)
1120 12/31/2010 26-1467691 09/23/2013 10/23/2023 2340 . 00
1120 12/31/2011 26-1467691 05/12/2014 06/11/2024 2340 . 00
1120 12/31/2012 26-1467691 05/12/2014 06/11/2024 2340 . 00
940 12/31/2011 26-1467691 05/14/2012 06/13/2022 132 . 56
941 12/31/2009 26-1467691 04/12/2010 05/12/2020 8657. 13
941 03/31/2010 26-1467691 06/21/2010 07/21/2020 8575 . 78
941 06/30/2010 26-1467691 06/20/2011 07/20/2021 1640 . 06
941 09/30/2010 26-1467691 06/06/2011 07/06/2021 524 . 92
941 12/31/2011 26-1467691 04/02/2012 05/02/2022 28135 . 33
941 12/31/2012 26-1467691 04/28/2014 05/28/2024 8168 .48
Place of Filing
Prothonotary
Cumberland County Total $ 62854 .26
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 09th day of September 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