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O1/04/2012 WED 14:29 FAX 402 471 4429 UCC SECRETARY OF STATE -�-�y 8a11 <br />�J003/006 <br />�� <br />Farm 668 (Y)(c) <br />(Rev. February 20041 <br />Department of the T�easury - Internal Revenue Service <br />l�otice of Federal Tax L�en �e 5e� af 5late Jehn H Gele - UCC Fn <br />Area: • Serial Number <br />SMAL7., HIISINESS/SELF EMPLOYED AREA #4 <br />Lien dJnit Phone: (S00) 913-6050 838512711 <br />As provided• by section 6329, 6322, and 6323 of the Internal Reveno�� <br />Code, we are givimg a nodce that saxes (including interest aad penal�ies) <br />have been assessed against the following eamed taxpayer. We have madie <br />a demand for payment of this liability, bat it remains �mpaid, Therefore, <br />there is a lien in favor of the llnited States on all property and �igbts to <br />property belonging to .this taxpayer for the amount �of these taxes, and <br />additional penatties, ioterest, and costs that may accrue. <br />20120009� <br />Fieside�ce 431 ROIISH LN • <br />' GR.AND ISLP,L�TD, NS 68801-8232 <br />Foi <br />9912681167-7 Pss: 1 <br />BERMUDEZ VHLDEMRR <br />Ftled: 01/04/2012 P18:33 H19 <br />IMPORTANT RELEASE INFORMATION For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined � <br />in IRC 6325(a). <br />Tax Period Dat� of last Day for <br />IGnd of Tax Endbng Identifying Number Assessment Refilung <br />(a) (b � (d) (@) <br />1040 12/3l/2007 XXX-XX-6665 06/27/2011 07/27/2021 <br />1040 l2/31/2008 XXX-XX-6665 10/04/2010 11/03/2Q20 <br />1040 12/31/2009 XXX-XX-6665 03/14/2011 04/13/2021 <br />Place of Filing <br />�inpa6d ��nce <br />o� �SSe�s�oer�� <br />].5333.5£; <br />55768.11 <br />�9374.28 <br />Register of Deeds <br />Hall POBOX 1692 <br />arand Islan.d, NE 68802-1692 <br />Totai 1$ 160475.97 <br />This notice was prepared and signed at � IL <br />4he 23rd day of December 2011 • <br />, <br />Signature <br />for ERIC MARTSN <br />, on this, <br />Tit{e <br />REVENUE OFFICER <br />(402) 473-4674 <br />2�-10-1721 <br />(AlOTE: Certificate of officer authorized by law to take acknowledgment is not essentiel to the validity of Rlotice of Federai Tax lie:� � <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) • Form b68(n(c' (Rev. 2-200�1) <br />Part 1- Kept By Recordlug Offite CAT. I�G S�2Fi?: <br />��� <br />