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0�4/12/2012 T8U 15:15 FAx 402 471 4429 UCC SECRBTARY OF STATE ��-� 8a11 <br />f�ooz/oo3 <br />� 11953 <br />� Department of the Treasury - internal Revenue Service <br />Form 668 (Y)(c) <br />.�Re� Februery 2004) Notice of Federal Tax Lien <br />A�ea: Serial IVumber For opdona <br />SMALL BUSINESS/SELF FI�LOYED AREA #� <br />Lien Unit Phone: (800) 829-3903 85891�712 <br />As provided by se�tion b321, 6322, and 6323 of the Internal Revenae <br />Code, we are giving a notice tbat taxes (including interest and penalties) <br />have been aueued against t6e fol[owing-named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the tlnited States on all property and rights to <br />property betonging to this taxpayer for the amount of the,se taxes, and <br />additional peaalties, interest, and costs t6at may aarue. <br />Name of Taxpayer OCTAVIO VENEGAS <br />Residence 142�4 E 7TH ST <br />GR.AND ISLAND, NE 68801-2922 <br />IMPORTANT REl.EASE INFORMATION: For each assessment listed below, <br />unless notic.e 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 certifica#e of release as defined <br />In IRC 6325{a). <br />Use by Recording Office <br />nse aven N 6s�e � UCC FTL <br />389864-3 Pss: 1 <br />�04/ 12 2012 i'� :36 pPi <br />�d�.�0-2�73 <br />Tax Period Date of Last Day for <br />Kind of Tax EndLng � Identifying Num6er Ats�ssment Refilidg <br />�04o iai3�/aoo� xxx-.�-o��62 os/oa/aoio o9/oi/aoao <br />ia4o i2/3i/aoos XXX-XX-Q762 o�/Za/aozo os/�.i/ao2o <br />Zo4o 12/31/2009 xxx-�-o�6a ia/o6/ZOio oi/o5/aoai <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Tsland, NE 68802-1692 <br />Total �$ 64942.59 <br />This notice was prepared and signed at CHICA.GO, IL <br />the 03rd day of April 2012 <br />, on this, <br />Signature . � C �� <br />for MICHAEL W. COX <br />Title <br />ACS SBSE <br />(800� 829- <br />llnpaid Balance <br />of Assessment <br />24-00-0008 <br />(NOTE: Cert+ficate of officer autfiorized by {aw to teke acknowiedgment is not essential to the validity of Notice of Federal 7ax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) ' Form 668('�(c) (Aev. 2-2004) <br />Part 1- Kept By Recordtng Office CAT. NO 60025X <br />22941.31 <br />12839.37 <br />29161.91 <br />� <br />: <br />Y <br />