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Department of the Treasury - Internal Revenue Service
(Rev.February 24404)4)
form 66 (YNotice of the
Tax Lien
Area: Serial Number For Optional Use by Recording Office
SMALL BUSINESS/SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913-6050 130737614 /
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, �
there is a lien in favor of the United States on all property and rights to -�� X"' s,
property belonging to this taxpayer for the amount of these taxes, and rrt � ,r r=
additional penalties, interest, and costs that may accrue. "� "Zm
r r")
Name of Taxpayer QUAN S LY -<3'
t`7
Residence
45 VICTORIA WAY
CAMP HILL, PA 17011-1728 "
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). )9 313vz/
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)
1040 12/31/2012 XXX-XX-8278 05/20/2013 06/19/2023 7744 .62
1040 12/31/2013 XXX-XX-8278 05/05/2014 06/04/2024 5953 .30
a
Place of Filing
Prothonotary
Cumberland County Total $ 13697 . 92
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 18th day of November 2014
Signature r"'i'�r-•� REVENUE OFFICER 22-06-2625
for MIGNA RODRIGUEZ (717) 777-9622
(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)
P2rr t .Kant Rv Rarnrdina Mira