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o <br />Foal 668 (Y)(c) <br />(Ray. February 2004) <br />14583 <br />Department of the Treasury - Internal Revenue Service 2014011 <br />Notice of Federal Tax Lien <br />Area. <br />SMALL f .TS SS /SELF 8MPLOYED AREA #4 <br />Lien Unit Phone: (800) 029 -3903 <br />Serial Number <br />984665514 <br />For Optional Use by Recording Office <br />4.1 <br />Y6 lye of 60 Jahn 6 6.r• - . Fri, <br />i; !; i' i <br />�f ��; <br />111111 ; �� ;� i ,,, ,''; � <br />� <br />9 <br />Flied: a�127/2af4 11:20 Aft PALACIOS "MON VERJAN pea: 1 <br />• <br />• <br />• <br />M 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 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 tali taxpayer for the amount of these taxes, and . <br />addfdonai penalties, interest, and costs that may accrue. <br />Name of Taxpayer RAMON VERJAN PALACIOS <br />Residence 7.414 SAINT PAUL RD TRLR 86 <br />GRAND ISLAND, NE 68B01 -2484 <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 8325(a). <br />ifind of Tax <br />(a) <br />Tax Period ' <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />List Day for <br />Relining <br />• (e) <br />Unpaid Balance <br />of Assessment <br />(.. <br />1040. <br />1040 <br />• <br />• <br />12/31/2009 <br />12/31/2010 <br />XXX -XX -0795 <br />XXX -XX -0795 <br />• <br />04/22/2013 <br />04/22/2013 <br />05/22/2023 <br />05/22/2023 <br />87444.45 <br />25387.97 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />. Grand Island, NE 68802 -1692 <br />$ 112832.42 <br />Feb, 27, 2014 3:13PM NE Secretary of State — UCC <br />No.3544 P. 3 <br />This notice was prepared and signed at CHICAGO IL , on this, <br />the <br />13th day of February 2014 <br />• <br />Signature e--,,r.•ticc... ACS USE , 24 - - 0008 <br />for Q.J. CARTER - LOUIS (800) 829 - 3903 <br />(NOTII Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Malice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 669(Y)(e) (Rev. 2 -2004) <br />Pare i - Knot M Rowan Mike CAT. NO 60025X <br />27 <br />