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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 1 . 126265614
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 C=
a demand for payment of this liability, but it remains unpaid. Therefore, -0:r
there is a lien in favor of the United States on all property and rights to =M C-77
property belonging to this taxpayer for the amount of these taxes, and
C:)
additional penalties, interest, and costs that may accrue. —4
Name of Taxpayer BEVERLY A & ABRAHAM F BROWNC�-I
:ll>C--)
Residence 11 CARLISLE RD c-n
NEWVILLE, PA 17241-9402
IMPORTANT
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 6
325(a).
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refiling of Assessment
(a) (b) (c) (d) (e) M
1040 12/31/2012 XXX-XX-3654 12/23/2013 01/22/2024 50847 .73
Place of Filing
Prothonotary
Cumberland County Total $ 50847 .73
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI on this,
the 22nd day of October 2014
Signature ACSTitle
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 6002siX