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02/O1/2012 W8D 15:20 FAX 402 471 4429 UCC SBCRETARY OF STATE -�-�� Hall <br />� .� <br />Form 668 (Y)(t) <br />(Rev. Fe6ruary 20041 <br />Area: Serial Number <br />SMFILL BU9INESS/SELF EMPLOYfiD AREA #4 <br />Lien Unit Phone: (800) 913-6050 843181112 <br />As provided by s�tion 63Z 1, 6322, and b323 of the Internal Revenue <br />Code, we are giving a notice that taxes (inciuding interest and penalties) <br />have been assessed against the following-named taxpayer. We have nrade <br />a demand for payment of. this liabiliry, but it remains unpatd. Therefore, <br />there is a lien in favor of the united States on aU property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may aurue. <br />Residence 115 S SYCAMORP ST <br />�GRAND ISLAND, NE 68801-6009 <br />For Optional Use by Recording Office <br />N6 Sec nf Siele John R Gele - UCC FTL <br />9912683967-5 Pes: 7 <br />QUIROS LUIS E <br />Filed: B2/01/2012 02:18 PM <br />�J002/004 <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 Date of I.ast D�ay for <br />Kind of Tax Ending tdentifying Nurober Assessment Refiling <br />1040 12/31/2001 <br />1040 12/31/2002 <br />1040 12/31/2004 <br />1040 12/31/2006 <br />Place of Filing <br />Department of the Treasury - Internal Revenue Service 2 p g 2 0 0� 5 0 <br />Notice of Federal Tax Lien <br />XXX-XX-2309 <br />XXX-XX-2309 <br />XXX-XX-2309 <br />XXX-XX-2309 <br />09/04/2006 10/04/2016 <br />09/04/2006 10/04/2016 <br />07/27/2009 08/26/2019 <br />07/27/2009 08/26/2019 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Isl and, NE 6880 <br />llnpaid Balance <br />of /essessment <br />38593.75 <br />54915.77 <br />30481.22 <br />6252.86 <br />Total I$ 130243.60 <br />This notice was prepared and signed at <br />the 18th day of January <br />CHICAGO, IL <br />2012 <br />, on this, <br />Signature Title <br />�'t� REVENUE OFFICER 24-10-1739 <br />for KAY PONTP � (308) 384-4850 <br />(NOTE: Certificate of officer authorized by lew to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) � Form 668(l�(c) (Rev. 2-2004) <br />Part 1- Kept By itecording Office CAT. NO 600257( •. <br />x <br />