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Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />923589213 <br />For Optional Use by Recording Office <br />NE <br />9913709866 <br />KLEIN <br />Filed: <br />sec <br />of <br />KR <br />03/04/2013 <br />State <br />STEN <br />-4 <br />John <br />F <br />A Gale <br />01 :35 <br />- <br />UCC <br />Pgs <br />PM <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 KRISTEN F KLEIN <br />Residence 17541 W AIRPORT RD <br />CAIRO, NE 68824 -9538 <br />IMPORTANT <br />unless notice <br />on the day <br />in IRC 6325(a). <br />RELEASE INFORMATION: For each assessment listed below, <br />of the lien is refiled by the date given in column (e), this notice shall, <br />following such date, operate as a certificate of release as defined <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />Date of <br />Assessment <br />(d) <br />Last Day <br />Refiling <br />(e) <br />for <br />Unpaid Balance <br />of Assessment <br />(0 <br />1040 <br />12/31/2009 <br />XXX -XX -5548 <br />11/05/2012 <br />12/05/2022 <br />80973.16 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />Total <br />$ 80973.16 <br />03/04/2013 MON 14:12 FAX 402 471 4429 UCC SECRETARY OF STATE <br />tf) <br />the <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />3595 <br />20th day of February 2013 <br />Rev. Rul. 71-466,1971 - 2 C.B. 409) <br />y■■ <br />Hall <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />201301710 <br />21 /006 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />Signature /"■e- Title <br />� C-'� REVENUE OFFICER 24 -10 -1744 <br />for PATRICK J KELLOGG (308) 384 -4850 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Form 668(Y)(c) (Rev. 2 - 2004) <br />Part 1 • Kept By Recording Office CAT. NO 60025X <br />