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05/16/2012 WSD 13:50 FAx 402 471 4429 UCC SECRETARY OF 5TATE -�y-� Ball �002/003 <br />Form 6b8 (l�(c) <br />(Rev. February 2004) <br />Department of the Treasury - Internai Revenue Service <br />Notice of Federal Tax Lien 2 412 0 3 9 2 3 <br />Area: Serial IVumber <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lie� Unit Phone: (800) 913-6050 866004912 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Cade, we are giving a notice that taxes (inctuding interest and penalties) <br />have been asseued against the fatlown�g•named ta�ayer. We have made <br />a demand for payment of this I�a6ility, but it remains uepaid. Therefore, <br />there is a iien in favor of the united States on aIl property and rights w <br />property belong�ng to this taxpayer for the amount of these taxes, and <br />additional penalties, tnterest, and costs that may accrue. <br />Residence . 660 FASDLEY CT APT B2 <br />GRAND ISLAND, �11fE 68803-3427 <br />Fo� <br />Use <br />ot�� <br />N8 Sae af 5la4a John A Gala - UCC FTL <br />9912692168-8 Pes: 7 <br />MCINTOSH JON P <br />Flled: 06/16/2012 08:68 RM <br />i <br />� <br />� <br />lMPOlLTAl1IT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is re�led by the date given in column (e1, 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 lde�ifjring Number l�sessment Re�iling <br />1040 12/31/2007 XXX-XX-6887 04/02/2012 <br />1040 12/31/2008 XXX-XX-6887 04/02/2012 <br />1040 12f31/2009 XXX-XX-6887 0�/02/2012 <br />104Q 12/31f2010 XXX-XX-6887 04i02/2012 <br />05/02/2022 <br />OS/02/2022 <br />05/02/2022 <br />�05i02/2022� <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, N8 68802-1692 <br />13796.20 <br />11607.04 <br />7635.94 <br />7421.32 <br />Total I$ 40460. So <br />This notice was prepared and signed at <br />the 04th day of May <br />CHICAGO, IL <br />2012 <br />, <br />Signature Title ' <br />����.� REVENIIE OFFICER 24-10-1744 <br />• for PATRICK J KELLOGG (308) 384-4850 <br />(NOTE: Cectificate of officer authorized by law to take acknowledgment is not essentiaV to the validity of Wotice o1 Federal Tax lien , <br />Rev. Rul. 71-466, i971 - 2 C.B. 409) Furm 668(Y)(t) (Rev. 2-2004) ' <br />Part 1- Kept By Recocding OfEite CAT. NO 60025X ` <br />linpa�d Balance <br />of Auessment <br />, on this, <br />