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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
WAGE & INVESTMENT AREA #1
Lien Unit Phone: (800) 829-7650 118820814 oZ �TZi
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 cr>
additional penalties, interest, and costs that may accrue. x 1-1 v
Name of Taxpayer BELVIN L & BRENDA J BANKSy�, _._►
-- cJ
Residence 415 S PENN ST C_- cz. .
SHIPPENSBURG, PA 17257-8885r F,a
FIRC
NT RELEASE INFORMATION: For each assessment listed below,
e of the lien is refiled by the date given in column (e), this notice shall,
following such date, operate as a certificate of release as defined
5(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)
1040 12/31/2009 XXX-XX-3131 05/31/2010 06/30/2020 3224 . 30
1040 12/31/2010 XXX-XX-3131 05/30/2011 06/29/2021
1040 12/31/2010 XXX-XX-3131 11/19/2012 12/19/2022 3883 . 63
1040 12/31/2012 XXX-XX-3131 06/03/2013 07/03/2023 5142 .35
Place of Filing
Prothonotary
Cumberland County Total $ 12250 .28
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 09th day of September 2014
Signature Title
C--�-� ACS W&I 11-00-0000
for DEANN BENDER (800) 829-7650
(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