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..Aug. 12. 2014 2:39PM. . NE Secretary of State — UCC <br />Form 666 (Y)(c) <br />(Rev. Februory 2004) <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: 1900) 913 -6050 <br />Name of Taxpayer EDWIN S ERLAND <br />Residence <br />Kind of Tax <br />(a) <br />1040 <br />Place of Filing <br />11883 <br />Tax Period <br />Ending <br />(b) <br />12/31/2010 <br />This notice was prepared and signed at <br />the <br />Signature <br />01st day of August <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Identifying Number <br />(c) <br />XXX -XX -172 5 <br />2014 <br />Serial Number <br />• 112902014 <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 lability, 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 />804 N BOGGS AVE APT 419 <br />GRAND ISLAND, NE 68803-4415 <br />w <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the Ilan is refiled by the date given in column (a). this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in RC 8325(a1 <br />Date of <br />Assessment <br />(d) <br />06/30/2014 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />CHICAGO, IL <br />Last ay fOr <br />(e) <br />07/30/2024 <br />Title <br />REVENUE OFPICER <br />(308) 663 -6003 <br />for PATRICK J KELLOGG <br />(NOM Certificate of officer authorized by law to take acknowledgment is not essential to the validly <br />Rev. Rul. 71 -466, 1971 - 2 G.B. 409) <br />For Optional Use by Recording Office <br />i[ C+. of SiNe 3 hn A e•lr - uec rn. <br />99147483e1 -0 Pss 1 <br />ERLAND EDN(N 5 <br />Filed; @9r1212214 11:14 AM <br />Tote! $ <br />No, 6124 P. 2 <br />201404990 <br />Unpaid Balance <br />of Assessment <br />(f) <br />79889.68 <br />79889.68 <br />, on this, <br />24 -06 -2744 <br />of Notice of Federal Tax lien <br />_ _ Form 116B(1)(c) (Rev. 2 -2004) <br />