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10/26/2012 FRZ 15:08 FAX 402 471 4429 UCC SECRETARY OF STATE -�-�-� Ha11 <br /> � <br />�J004/00 <br />Department of the Treasury - Internal Rev�nue Service� �� 2 0 9 0 4�. <br />Forai 668 (Y)(c) Notice of Federat Tax Lien <br />IRev. Febtuary 2004) <br />Area: Serial Number <br />SMA.LL BUSSNE3S/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (8a0) 913-6050 900022212 <br />As provided 6y section 6321, 6322, and 6323 of the Internal Rcvenue <br />Code, we are giv'rng a notice that taxes (inctud�tn� interest and penalaes) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for payment of this 6a6ility, hut it remains unpaid. Therefore. <br />there is a lien in favor of the llnited States an all property and rights to <br />property belonging to this taxpayer for ti►e amouet af these taxes, and <br />additionaf penalties, interest, and cotts that may accrue. <br />Name of Taxpayer RAFAEL OROZCO � <br />RAFAS TACOS <br />Residence 2105 NASHVTLLE ST <br />GRAND ISLAND, NE 68803-1539 <br />For Optiona! Use by Recording Office <br />IMPORTANT RELEASE 1NF01LMAT10N For each assessment listed below, <br />unless notice o� 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(a1. <br />Tax Period Date of I.ast Da�y for <br />Kind of Tax Ending Identifying Number Assessment Re�iling <br />940 �12f31/2010� 27-0018371 �04/16/2012, 05j16/2022 <br />Place of Fifing <br />This notice was prepared and signed at ���GO, IL <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NB 68802-1692 <br />llnpaid Balance <br />oE-Assessment <br />151.38 <br />Tota! �$ 151. 3 8 <br />, on this, <br />the 16th day of October 2012 <br />Signature �-��.� Title <br />\ \�� REVENIIE OFFTCER 24-10-174� <br />for PATRICK J KELLOGG (3�8) 384-4850 �\� <br />(N07'E: Certificate of officer authorized by law to take acknowledgment is not essential tu tha validity of IVotice of Federal Tax lien <br />Rev. Rul. 71-466, t 971 - 2 C.B. 409) Form 6b8(�(t) (Rev. 2-2004) <br />Part 1- Kep� By Recording Office CAT. NO 60025X <br />