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Form 668 (Y)(c) <br />(Rev. February 2004) <br />3595 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien 2 013 012 5 9 <br />Area: <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829 -7650 <br />Serial Number <br />918648713 <br />For Optional Use by Recording Office <br />NE <br />9913708744 <br />FEeeds <br />Sec <br />of Stele <br />ROGELIO <br />-5 <br />Jelin <br />RGale <br />010:36 <br />- <br />UCC <br />Pes <br />AM <br />FTL <br />1 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <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 />Name of Taxpayer ROGELIO ADORNO FEBRES <br />Residence 1414 N ST PAUL RD TRL 73 <br />GRAND ISLAND, NE 68801 <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 />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refiling <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />1040 <br />1040 <br />12/31/2005. <br />12/31/2006 <br />12/31/2007 <br />XXX -XX -4422 <br />XXX -XX -4422 <br />XXX -XX -4422 <br />_ <br />03/30/2009 <br />03/30/2009 <br />05/24/2010 <br />04 <br />04 <br />06/23/2020 <br />1052.99 <br />7616.36 <br />9545.05 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 18214.40 <br />02/14/2013 THU 14:57 FAX 402 471 4429 UCC SECRETARY OF STATE -+-.-. Hall <br />This notice was prepared and signed at <br />the 25th day of January 2013 <br />Signature /";■e-� Cam{ <br />for PAMELA J ROGERS <br />E1002 /003 <br />CHICAGO, IL , on this, <br />Title <br />ACS W &I <br />(800) 829 -7650 <br />14 -00 -0000 <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 I - Kept By Recording Office CAT. NO 60025X <br />