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Department of the Treasury - Internal Revenue Service
Form 668 (Y)(C)
(Rev, February 2004)
Notice of Federal Tax Lien
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For Optional Use by Recording Office
Area: Serial Number
SMALL BUSINESS/SELF EMPLOYED AREA #2
lien Unit Phone: (800) 913-6050 322000606
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.
Name of Taxpayer TARA NEGLEY
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Residence
1500 BRIDGE ST
NEW CUMBERLND, PA 17070-1119
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).
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Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilmg of Assessment
(a) (b) (c) (d) (e) (0
941 12/31/2001 25-1775645 12/12/2005 01/11/2016 615.25
941 12/31/2002 25-1775645 12/26/2005 01/25/2016 763.09
941 06/30/2003 25-1775645 06/20/2005 07/20/2015 581.27
941 09/30/2003 25-1775645 07/11/2005 08/10/2015 1193.24
941 12/31/2003 25-1775645 06/13/2005 07/13/2015 1419.23
941 06/30/2004 25-1775645 06/13/2005 07/13/2015 1812.83
941 09/30/2004 25-1775645 09/19/2005 10/19/2015 1660.08
941 12/31/2004 25-1775645 09/19/2005 10/19/2015 1859.12
941 03/31/2005 25-1775645 06/20/2005 07/20/2015 1560.09
941 06/30/2005 25-1775645 10/10/2005 11/09/2015 1386.74
Place of Filing
Prothonotary
Cumberland County Total $
Carlisle, PA 17013
This notice was prepared and signed at DETROIT / MI
12850.94
, on this,
2006
12th day of October
the
Title
REVENUE OFFICER
(717) 221-3490 x1320
Signature
for DAVID M. SHROYER
22-06-1442
(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)
Part 1 - Kept By Recording Office
Form 668(Y)(c) (Rev, 2-2004)
CAT, NO 60025X