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Form 668 (Y){c} Department of the Treasury - Internal Revenue Service
(Rev.February 2404) 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 132364614 7t7�� �.-�
As provided by section 6321, 6322, and 6323 of the Internal Revenue
Code, we are giving a notice that taxes (including interest and penalties)
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have been assessed against the following-named taxpayer. We have made c� 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
property belonging to this taxpayer for the amount of these taxes, and n -0
additional penalties, interest, and costs that may accrue. o
Name of Taxpayer ANDREA L KORETZ c—z
Residence
416 ORCHARD LN
MECHANICSBURG, PA 17055-6141
IMPORTANT RELEASE INFORMATION: For each assessment listed below,
unless notice of the lien is refiled by the date given in column (e), this notice shail,
on the day following such date, operate as a certificate of release as defined ��...
in IRC 6325(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)
1040 12/31/2009 XXX-XX-0691. 09/24/2012 10/24/2022 22529.79
i
Place of Filing
Prothonotary
Cumberland County Total $ 22529 . 79
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 27th day of November 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 G.B. 409) Form 668(Y)(c) (Rev. 2-2004)
Part I -Kent By Recordine Office — ..„ ,,,.---11