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Jan. 22. 2014 2:34PM NE Secretary of State — UCC 2 01 40 0 9 2973 P. 3/3 <br />one 668 (Y)(c) <br />!Rev. Fearuarr 2004i <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #5 <br />Lien Unit Phone: (Boo) 913 -6050 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Cade, we are giving a notice that taxers (including Interest and penalties) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for payment of thb i'wbility, 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 amormt of these taxes, and <br />additional peraltles, interest, add costs that may accrue. <br />Name of Taxpayer JERRY & CAROLE DENTON <br />Residence <br />I MPORTANT RELEASE INFORMATION: For each assessment fisted below, <br />F ., <br />notloe of the lien is refilod by the date given in column (el, this notice siraU, <br />o n the day following such date, operate as a certificate of release a defined <br />i n IRC 6325(a). <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br />Place of Filing <br />Tax Period <br />Whig <br />. (b) <br />14583 <br />1513 STAGECOACH RD <br />GRAND ISLAND, NE 68801 <br />12/31/ <br />12/31/2012 <br />This notice was prepared end signed at <br />Signature <br />for SHERI ROY <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Identifying Number <br />(c) <br />XXX -EX -3010 <br />xXX —XX - 3010 <br />Serial Number <br />Date of <br />Assessment <br />(d) <br />11/19/2012 <br />11/25/2013 <br />Register of Deeds <br />Hall MME0% 1692 <br />Grand Island, NE 68802 - 1692 <br />the 08th day of January 2014 <br />CHICAGO, IL <br />977546714 <br />Last Day for <br />Renting <br />(e) <br />12/19/2022 <br />12/25/2023 <br />For Optional Use by Recording Office <br />NE Ere of Et.E4 Jahn P E&Ia - U[[ rn. <br />8914728371 -1 Pam: 1 <br />DENTON JW RY <br />Filed: 01/22/2014 10:61 AM <br />Total <br />Unpaid <br />A el Balance <br />30411.60 <br />38581.32 <br />$ 68992.92 <br />, on this, <br />Title f'\ <br />REVENUE OFFICER 25 -15 -3309\ <br />(318) 503 -2053 °.N <br />(1110T74 Certificate of officer authorized by law to take acknowledgment la not essential to the validity of Notice of Federal Tax lien <br />Rev. Rui. 71-46& 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -20041 <br />Part 1 - Kau Iv Racatdlaff Office PAT in P.nn9F3( <br />