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10/19/2012 FRi 15:25 FAX 402 471 4429 UCC SECRSTARY OF 5TATE -�-�� Hall <br />O�or� 668 (ln(c) <br />(Rev. February 2004) <br />3 <br />Departmer►t of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien � 0� 2 0� 7�(� <br />Area: . Serial Number For Optional Uss by Hecording Office <br />SMALL BIISINESS/SEI,F EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 898502412 <br />As provided by sectfion 6321, 6322, and 6323 of the Internal Reven�ee <br />Code, we are �vn�g a aotice that taxes (including interest and penalties) <br />have b�n assessed against the following-named taxpayer. We have made <br />a demand for payment of this tiability, but it remains unpaid. Therefore, <br />there is a Gee in favor of the United States on aU proper�ty autd rights to <br />property belonging to this taxpayer for the amow�t of these taxes, and <br />additional penalties, interest, and costs t�at may aarue. <br />Name of Taxnaver.0 VENEGAS RODRIGIIEZ & S NIEVES ATAY <br />Residence 1424 P 7TH ST <br />GRAND ISLAND, NE 68801-2922 • <br />IMPORTANT RELEASE INFORMATION: For each assessment tisted 6e1ow, <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 63251a). <br />Tax Period Date of Last Da�y for <br />Kind of Tax Ending ldentifying Number Assessment Refiling <br />1040 12/31/2010 XXX-XX-0762 02/13/2012 03/15j2022 <br />104Q 12/31/2011. XXX-XX-0762 06/04/2012 07/04/2022 <br />llapaid Balance <br />of Asseument <br />10.677 . 07 <br />2710.99 <br />t <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total I$ 13388.06 <br />This notice was prepared and signed at <br />the 09th day of October <br />CHICAGO, IL <br />2012 <br />, on this, <br />Signature � �{ <br />� � <br />for G.J. CARTER-LOUIS <br />Title <br />ACS SBSE <br />(800) 829-3903 <br />24-00-0008 <br />(NOTE: Certificate ot offlcer authorized hy law to take acknowledgmsnt is not essential to the validity of Motice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(�(c) (Rev. 2-2004) <br />Part 1- Kept By Rewrdiog Office CAT. NO 60025X <br />�ooz/oo2 <br />i <br />� <br />Y • <br />