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Sep. 24 2014 3:00PM NE Secretary of State — UCC <br />Form 669 (Y)(c) <br />tliev. February 2004) <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA # <br />Lien Unit Phone: (800) 913 - 5050 <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 penahles, htterest, and costs that may accrue. <br />Name of Taxpayer ROBERT S IEMERS <br />Residence <br />kind of Tax <br />(a) <br />1040 <br />Place of Filing <br />Signature <br />11883 <br />for PATRICK a KELLOGG <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <br />5076 W ABBOTT RD <br />. GRAND ISLAND, NE 68803 -9426 <br />• <br />sal esseesmsr- Iladed -Below <br />unless notice of the lien is refiled by the date gluon 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 />Tax End d i eng <br />(b) <br />12/31/2010 <br />This notice was prepared and signed at <br />Identifying Number <br />(c) <br />7Q X -XX -2584 <br />the 10th day of Septemb 2014 <br />Date of <br />Assessment <br />(d) <br />11/26/2012 <br />Register of Deeds <br />gal). POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />CHICAGO, IL <br />Part 1- Kept By Recording Office <br />119152814 <br />1 tDay far <br />(e) <br />12/26/2022 <br />Title <br />REVENUE OFFICER <br />(308) 663 -6003 <br />No. 6840 P. 2/2 <br />201406084 <br />For Optional Use by Recording Office <br />N! Le M Maio John 11 MIS - UCC FTL <br />111/I 111111 <br />9914747337 -8 Pus: 1 <br />E MMERE ROBERT <br />11ed: 0912412014 1e:31 AM <br />Unpaid Balance <br />of Assessment <br />• <br />(1) <br />13757.01 <br />Total $ 13 757.01 <br />on this, <br />24 -06 -2744 <br />\ <br />(NOTE; Certificate of officer authorized by Hew to take acknowledgment is not essential to the validity of Notice of Federal Teak lien <br />Rev. Rk1. 71 -468, 1971 - 2 C.B. 4091 Form 66i(Y)(c) ;Rev. 2 -2004! <br />CAT. NO 60026X <br />