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Dec. 3. 2013 2:40PM NE Secretary of State — UCC No. 2147 P. 3 <br />0 8 ' <br />Form 669 (Y)(c) <br />(Rev. February 20041 <br />Residence <br />Kind of Tax <br />(a) <br />1040 <br />Place of Filing <br />14583 <br />Area: <br />'SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 - 6050 <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 Rabidity, but it remains unpaid. Therefore, <br />there is a Ilen 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 MAGDALENO & ARACELI VASQUEZ <br />1516 W 3RD ST <br />GRAND ISLAND, NE 68801 -5724 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />4 <br />Tax Period <br />Ending <br />bb_ <br />12/31/2012 <br />This notice was prepared and signed at <br />Identifying Number <br />(c) <br />XXX - XX - 9105 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />the 22nd day of November 2013 <br />Signature <br />•for DANIELLE L MUELLER <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <br />Date of <br />(d) <br />09/02/2013 <br />CHICAGO, IL <br />970590213 <br />Last Day foT <br />(e) <br />10/02/2023 <br />Title <br />REVENUE OFFICER <br />(402) 473 -4675 x2912 <br />201309424 <br />For Optional Use by Recording Office <br />A S IICC Mt <br />, E S ■e pr $ Jahn <br />99 yp5 No Pas: 1 <br />Filed: 1210612013 10 :3 AM <br />Total <br />of <br />6013.96 <br />$ 6013.96 <br />, on this, <br />24 -10 -1720 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax Ilen <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 669(Y)(c) (Rev. 2-2004) A[ {�y <br />Paw 1 . E Qemrdier Office Form lift RM9I.Y ,C <br />