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Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />912395312 <br />For Optional Use by Recording Office <br />As provided by section 6321,- 6322, and 6323 of the Internal Revenue <br />NE Sec of Safe John ft Gale - UCC FT <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following -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 United States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />9912705483 <br />CARSON GARY <br />-6 <br />H <br />PSIS: <br />1 <br />Filed: 12/31/2012 10:32 AM <br />Name of Taxpayer GARY H CARSON <br />Residence 4540 W 13TH ST <br />GRAND ISLAND, NE 68803 -2817 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <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 6325(a). <br />• <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2004 <br />XXX -XX -0413 <br />08/01/2011 <br />08/31/2021 <br />9414.33 <br />1040 <br />12/31/2007 <br />XXX -XX -0413 <br />07/16/2012 <br />08/15/2022 <br />30135.11 <br />1040 <br />12/31/2008 <br />XXX -XX -0413 <br />07/16/2012 <br />08/15/2022 <br />35616.23 <br />1040 <br />12/31/2009 <br />XXX -XX -0413 <br />08/13/2012 <br />09/12/2022 <br />17752.47 <br />1040 <br />12/31/2010 <br />XXX -XX -0413 <br />08/13/2012 <br />09/12/2022 <br />28215.90 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 121134.04 <br />Grand Island, NE 68802 -1692 <br />12/31/2012 MON 12:55 FAX 402 471 4429 UCC SECRETARY OF STATE Hall <br />SC <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />3592 <br />This notice was prepared and signed at <br />the 17th day of December 2012 <br />Signature C-4364.„ <br />for PATRICK J KELLOGG <br />Department of the Treasury - Internal Revenue Service <br />2 ©1211229 <br />Notice of Federal Tax Lien <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -2004) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />0002/006 <br />CHICAGO, IL , on this, <br />Title <br />REVENUE OFFICER <br />(308) 384 -4850 <br />24 -10 -1744 <br />