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01/04/2012 6TED 14:29 FAX 402 471 4429 UCC SECRETARY OF STATE y-�� 8a11 <br />s <br />��' Fo� 668 mc�� <br />lRev. February 2004) <br />05/30/2011� 06/29/2021 <br />Area: Serlal Number <br />SMALL BUSIIQESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone (800) 913-6050 837829•611 <br />,Ils provided by section 632 t, 6322, and 6323 of the internal Revenuc <br />Code, we are giving a notice that taxes (including interest aad penalties) <br />have been assesssed against the following-named taxpayer. We have made <br />� demand for payment of this Iia6iGty, but it remains unpaid. Therefare, <br />there is a lien in favor of the Unit� States on all property and ri�ts to <br />property belong'mg to this taxpayer for the amount of thes� taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name <br />Residence 4435 CALVIN DR <br />GRAND ISLAND, NE -68801-8713 <br />F <br />IMPORTANT RELEASE 1NFORMATION: 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, opsrate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period Date of I.ast 6ay for <br />ICind of Tax Ending Identifying Number Assessment I�eflling <br />1040 �12/31/2010� XXX-XX-2544 <br />Place of Filing <br />Register of Deeds � <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />7�6.82 <br />Total �$ 776.8?. <br />This notice was prepared and signed at � CHICAGO, IL � , on this, <br />the Zlst day of December 2011 <br />Signature <br />for PATRICK J <br />Title <br />REVENUP Ok'FICER <br />(308) 384-4850. <br />�ooz�oo6 <br />24-10-1744 <br />(NOTE: Certificate of officer euthorize� by law to take acknowledgment is not essential to the vaGdity of Notica of Federa! Tax lien <br />Rsv. Rul. 71-46B, 1971 - 2 C.B. 409) . Form 668i(Y2(c) IHev. 2-2004) <br />. Part t- K�t By Raordfng ONice CAT. N4 6Q025X <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Ti ax I.ien , <br />N Oele - U[C Fri <br />a9s: � <br />08:33 A19 <br />20�200099 <br />l9npa6d �[aunc� <br />a� �S.ses�ent <br />