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»one b68 (Y)(c) <br />(Rev. February 20441 <br />11883 <br />venue Service 2 0 1 A 0 6 8 r <br />Deparrmmenntt of the Treasury - _ I r nternal Revenue `t <br />Notice of Federal Tax lien 0 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (80D) 913 -5050 <br />Serial Number <br />125248514 <br />For Optional Use by Recording Office <br />Sea K 5..y ighn a a`. <br />1110 <br />M47 44015-6 <br />Fl PIUCE 18/29/2014 1z: <br />• • <br />use Fit <br />1111 <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 al 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 />aa:: , <br />PM <br />. <br />Name of'faxpayer CARLOS BERMUDBZ <br />Residence 311 E 5TH ST <br />GRAND ISL? D, NE 68801-4618 <br />I AEI <br />I MPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the hen is raffled by the date given in column (e), this notice shall, <br />on the •day following such data, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last _ Dv for <br />Refhfmg <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />12/31/2012 <br />XXX -XX --4796 <br />02/24/2014 <br />03/25/2024 <br />1477.42 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692. <br />$ 1477.42 <br />Oct.29. 2014 3:23PM NE Secretary of State — UCC <br />This notice was prepared and signed at CHICAGO, IL <br />the 16th day of October 2014 <br />Signature . r �� Teti* OFFICER <br />for PATRICK J KELLOGG (308) 663 - 6003 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment Is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rui. 71 -488. 1871 - 2 C.B. 409) Form 6610)(e) (Rev. 2 - 2004) <br />CAT. NO 60025X <br />Part 1 - Kept DD Recording Office <br />No. 7386 <br />on this, <br />24 -06 -2744 <br />