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ltin 668 (Y)(c) <br />(Rev. February 2004) <br />3595 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien 1 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />956694113 <br />For Optional Uaa by Recording Office <br />I. Sec <br />913722463 <br />TRUELL <br />Filed: <br />of <br />' <br />t <br />114a41, <br />"'" <br />09110/2013 <br />-7 <br />John <br />" <br />N Gala. <br />UCC ITL <br />1111 <br />Po: 1 <br />:25 AM <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 followi ng-na med tax <br />payer. We have made 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 />� <br />09 <br />Name of Taxpayer JAMES H TRUELL & KARLA J ANDREASEN <br />• <br />Residence 903 W DIVISION ST <br />GRAND ISLAND, NE 68801 -6451 <br />IMPORTANT <br />unless notice <br />on the day <br />in IRC 8325(a). <br />RELEASE INFORMATION: For each assessment listed below, <br />of the lien is Wiled 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 />Reding <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />12/31/2009 <br />XXX -XX -6144 <br />08/05/2013 <br />09/04/2023 <br />25767.07 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 25767.07 <br />Sep. 10, 2013 2:55PM NE Secretary of State — UCC <br />This notice was prepared and signed at CHICAGO, IL <br />the 21st day of August 2013 <br />Signature <br />for CAROL HALL <br />Title <br />REVENUE OFFICER <br />(402) 473 -4673 <br />No. 0845 P. 2/3 <br />, on this, <br />24 -10 -1732 <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 />Form 669(Y)(c) (Rev. 2.2004) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />