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Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (80 913 -6050 <br />Serial Number <br />926221813 <br />For Optional Use by Recording Office <br />NE Sao <br />8913711524 <br />WEBER <br />Filed: <br />of <br />State <br />DWAYNE <br />03/26/2013 <br />John <br />-4 <br />A <br />Gale <br />10:55 <br />- UCC <br />Pes: <br />AM <br />PI <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 DWAYNE WEBER <br />Residence 304 W WALNUT ST <br />DONIPHAN, NE 68832 -8904 <br />IMPORTANT <br />unless notice <br />on the day <br />in IRC 6325(a). <br />RELEASE INFORMATION: <br />of the lien is refiled <br />following such date, <br />For each assessment listed below, <br />by the date given in column (e), this notice shall, <br />operate as a certificate of release as defined <br />Kind of Tax <br />( <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day <br />(filing <br />`...(e <br />for <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />1040 <br />12/31/2009 <br />12/31/2010 <br />XXX -XX -3950 <br />XXX -XX -3950 <br />02/06/2012 <br />11/14/2011 <br />03/`8 <br />12/4.4/2021 <br />749.02 <br />10096 .48 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />)` <br />$ 10845.50 <br />( <br />03/26/2013 TUE 15:04 FAX 402 471 4429 UCC SECRETARY OF STATE <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />14845 <br />06th day of March 2013 <br />-.-. -1 <br />Hall <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />10005 /007 <br />201302377 <br />Signature Title <br />ACS SBSE 24 -00 -0008 <br />for G.J. CARTER -LOUIS (800)829 -3903 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential t (he validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Form 668(Y)(c) (Rev, 2 -2004) <br />Part 1 - Kept By Recording Office <br />CAT. NO 60025X <br />