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rm 668 (Y)(c) <br />(Rev. February 2004) <br />3595 <br />Department of the Treasury - Internal Revenue Service <br />2013055 5p <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />946354313 <br />For Optional Use by Recording Office <br />NE <br />1 <br />9913718495 <br />Filed: <br />See of <br />1 <br />OCR <br />Stale <br />1 <br />07/ <br />John A Gale <br />I 111111 <br />-6 <br />10/20 01:30 <br />- UCC <br />111 <br />P9s: <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 RICHARD B BEAMON <br />Residence 1205 CEDAR RIDGE COURT BI <br />GRAND ISLAND, NE 68803 -1264 <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 />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refiring <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />12/31/2012 <br />XXX -XX -1964 <br />06/03/2013 <br />07/03/2023 <br />6175.41 <br />• <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 6175.41 <br />07/10/2013 WED 15:01 FAX 402 471 4429 UCC SECRETARY OF STATE <br />This notice was prepared and signed at <br />the 24th day of June 2013 <br />Signature <br />for DANIELLE L MUELLER <br />CHICAGO, IL <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) <br />Part 1 - Kept By Recording Office <br />Hall <br />Title <br />REVENUE OFFICER <br />(402) 473 -4675 x2912 <br />II002 /002 <br />, on this, <br />24 -10 -1720 <br />Form 668(Y)(c) (Rev. 2 -2004 <br />CAT. NO 60025X <br />