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Form 669 (Y)(c) <br />(Ray. February 2004) <br />3595 <br />Department o f the Treasury Revenue Si <br />ury - Internal Reenue ery <br />a X 0 1 404049 <br />Notice of Federal Tax Lien <br />Area: <br />SMALL SUS SS /SELF EMPLOYED AYas2a #4 <br />Lien Unit Phone: (000) 913 -6050 <br />Serial Number <br />106315314 <br />For Optional Use by Recording Office <br />. <br />Ne ' ea s..4. .rahn A Go 1• - UCC Fa <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 hi 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 />I 1 111 1111 ill <br />p 1 <br />9914756362- t MODALENO <br />Flied: 07/02!2014 93:26 PM <br />• <br />Name of Taxpayer MAGDALENO & AR.A.CELI VASQUEZ <br />Residence 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 rented 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 IRE 8325(al. <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />• <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(0) <br />Last Day for <br />Reuling <br />(e) <br />Unpaid Balance <br />of Assessment <br />- (f) <br />1040 <br />1040 <br />12/31/2011 <br />12/31/2011 <br />XXX -XX -9105 <br />XXX -XX -9105 <br />11/12/2012 <br />04/28/2014 <br />12/12/2022 <br />05/28/2024 <br />• <br />10375.19 <br />Piece of Filing <br />Register of Deeds - <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 103 75.19 <br />ul. <br />2014 3:59PM NE Secretary of State — UCC <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the 24th day of June 2014 <br />Signature r�" <br />for DANIELLE L MaELL <br />R3VENUE OFFICER' <br />(402) 473 -4675 3t2912 <br />No. 5596 P. 4/5 <br />24 -10 -1720 `. <br />(NOTE Carrifloeta of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul, 71 -486, 1071 - 2 CA. 409) <br />Part 1 • kept Bs Recording mice Form 666(n(c) (Rev. 2- 2004.) <br />CAT. NO 60025X <br />