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Fonts 669 (Y)(c) <br />(Rev. February 2004) <br />3758 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien 2 013 0 8 0 3 9 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA # <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />962B47813 <br />For Optional Use by Recording Office <br />NE <br />9913723752 <br />CARSON <br />Filed: <br />le. <br />► <br />of <br />!'1� <br />i! <br />! <br />GARY <br />10/02/2013 <br />siaie <br />-1 <br />John <br />H <br />ii Gale - <br />01:47 PM <br />• <br />uce: cn. <br />iii <br />l <br />pas: 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 GARY H & MARILYN M CARSON <br />Residence 4540 W 13T11 ST <br />GRAND ISLAND, NE 68803 -2817 <br />IMPORTANT <br />unless notice <br />on the day <br />in IRC 6325(a). <br />RELEASE INFORMATION: <br />of the lien is refired <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 />(a) <br />Tax Period <br />Ending <br />( <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 />1040 <br />1040 <br />1040 <br />12/31/2005 <br />12/31/2006 <br />12/31/2011 <br />12/31/2012 <br />XXX -XX -0413 <br />XXX -XX -0413 <br />XXX -XX -0413 <br />XXX -XX - 0413 <br />09/02/2013 <br />09/09/2013 <br />06/17/2013 <br />06/17/2013 <br />10/02/2023 <br />10/09/2023 <br />07/17/2023 <br />07/17/2023 <br />8187.85 <br />27679.99 <br />15738.06 <br />7429.75 <br />Place of Filing <br />Register of Deeds • <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 59035.65 <br />Oct. 2. 2013 2:07PM NE Secretary of State — UCC <br />No. 1221 P. 2/2 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the 24th day of September 2013 <br />Signature /^•■•••.. Title <br />K J KELLOGG, 384 -4850 <br />(NOTE: Cer <br />REVENUE OFFICER 24 -10 -1744 <br />for PATRICK (308) tificate of officer authorized by law to take acknowledgment in not easendal to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 Form 669 <br />Part I - Kept By Recant* Office ( AT (Rev. 2 -2004) /� <br />CAT. NO 60025X <br />