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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
SMALL BUSINESS /SELF EMPLOYED AREA #2
Lien Unit Phone: (800) 913 -6050 936430413 /3 S— r - 7 Z ,
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. rn � .�
Name of Taxpayer TIMOTHY D ARNOLDi
a t
Residence 6995 WERTZVILLE RD b� " CD --
MECHANICSBURG, PA 17050 -1541 "' .F
(7�- co
IMPORTANT RELEASE INFORMATION For each assessment listed below ire X-
unless notice of the lien is refiied 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). j?,, � � a, 99DIL�oZ
Tax Period Date of Last Day for Unpaid Balance
Kind of Tax Ending Identifying Number Assessment Refilling of Assessment
(a) (b) (c) (d) (e) (f)
1040 12/31/2005 XXX -XX -6176 04/15/2006 05/15/2016
1040 12/31/2005 XXX -XX -6176 08/09/2010 09/08/2020
1040 12/31/2005 XXX -XX -6176 12/10/2012 01/09/2023 40144.62
1040 12/31/2009 XXX -XX -6176 05/10/2010 06/09/2020
1040 12/31/2009 XXX -XX -6176 12/19/2011 01/18/2022 919.04
Place of Filing
Prothonotary
Cumberland County Total $ 41063.66
Carlisle, PA 17013
This notice was prepared and signed at DETROIT, MI , on this,
the 29th day of April 2013
Signature Title
REVENUE OFFICER 22 -06 -1418
for JAKOB PEDERSEN (717) 777 -9621
(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