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02/29/2012 WED 15:07 FAx 402 471 4429 UCC SSCRETARY OF 5TATE �-�-� Hall <br />� F�lnl 668 (Y)(c) <br />(Rev. Fehruary 20D4) <br />Area: <br />WAGE & INVESTMEI�TT AREA #2 <br />Department of ihe Treasury - Internal Revenue Service <br />�ot�ce af Fede�a! 1"� L��� <br />Seriel Number For Option: <br />20120160`7 <br />Use by Recording Office <br />�..�, <br />Lien Unit Phone: (800) 829-7650 I 850352212 <br />d1s provided by section 63� 1, 6322, aed 6323 0� the lnterna[ I�evenue <br />Cafe, we are grving a notice ti�at taxes (including interest and pe�talt8es) <br />have heen assessed against the follow�inng-named taxpayer. We f�ave rn�ad� <br />a demand for pay�nent of t1►is liabil8ty, bat it remains unpaid. Theref��r�, <br />there is a 6en in favor of the llnited Statea an all properhi a�d� rig�+�.s eo <br />property belonging w this taxpayer for the amount of these �aaxes, ar�� <br />additional penalties, interest, and costs t6at may accrue. <br />Residence 643 MEVES AVE . � <br />GRAND ISLAND, NE 688U1-7860 <br />IMPORTA111T RELEASE 1i�IF4RMAT10N For each assessme;tit listed below•, <br />unless notice of the lien is refiiled by the date given in column (e), this notice shaft, <br />on the day following such date, operate as a certiticate of release as dofined <br />in IRC 6325(a1. <br />Tax Period �►ate o� Last Da�r f�r <br />[Cind of Tax Ending lden�i�'yia�g Nee�nh�e� Assesamen� � R�fil�n� <br />�.04 0 <br />12/31/2009 XXX-XX-883Q I11/O1/2010� 12/01/2020 <br />Unpaid �alae�c� <br />�� t�ss�esse�e�t <br />3993a.43 <br />'l <br />i� <br />; <br />I <br />� <br />I <br />i <br />' h <br />Place of Filing <br />�J003/004 <br />Register of Deeds . <br />Hall PUHOX 1692 <br />Grand Island, NE 68802-�.6g2 <br />Tot3! j $ <br />This n�tice was prepared and signed aY CHICAGO, IL' <br />the 17th day of February 2012 <br />, <br />399:34 . �3 <br />, un this, <br />Signature ��� Title <br />ACS W&I 1+�-�0•-Jt)00 <br />f or PAMELA J ROGERS ( 8 Q Q 1 S 2�••`i 6 '�:: <br />(NOTE: Certificate of officer authorized by law to take actuiowledament is not esser,s.:;,i �:�� th� vatiditv r,i �vatic$ cf Fadaraf T:�x 3i-�: <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) <br />IPart f- K c B Recordii� O�:ice `arm 668(Y)(t) �R�v. 2.2004'� <br />� r s cMr. ..� E.,..2,;.� <br />; <br />� <br />i <br />�L � <br />