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Form 668 CO(c) <br />(Rev. February 2004) <br />11290 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />Emma, BUSINESS /SELF EM L0YED AREA #4 <br />Lien Unit Phone: (800) 829 -3903 • <br />Serial Number <br />139376615 <br />For Optional Use by Recording Office <br />Ne Set .4 f1ario John A e.ie - ucc Fh, <br />As provided by section Code, we giving a notice i that 6322, <br />taxes (Including 3 Interest Internal <br />nd penalties) <br />1111 0 <br />have been assessed against the following -maned taxpayer. We have made <br />a demand for payment of ails liability, but it remains unpaid. Therefore, <br />there k a lien in favor of the United States on all property and rights to <br />Pas; 1 <br />property belonging to this taxpayer for the amount of them taxes, and <br />� arb670 s <br />Pi exiesn 015 1A:17 FM! <br />additional penalties, interest, and costs that may accrue. <br />201500 7 <br />Name of Taxpayer RUBEN 9 GAMERO & EVA GIIERRA- ESCORAR <br />Residence 2323 BELLWOOD DR <br />GRAND ISLAND , NE 68801 -6209 <br />IMPORTANT RELEASE INFORMATION: For each assessment fisted 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 6325(a). <br />Tait Purled <br />Date of <br />Lask Dpu�i for <br />U vaid ®glance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />l�ig <br />0 Assessneent <br />10410 <br />12/31/2011 <br />YYY- X1..5343 <br />04/07/2014 <br />0S/0712024 <br />19556.97 <br />1040 <br />12/31/2012 <br />3iIGC -XX -5343 <br />06/25/2014 <br />09/24/2024 <br />25855.66 <br />• <br />• <br />• <br />Plate of Filing <br />Register of Deeds <br />• <br />Hall POBOX 1692 • Total <br />$ 45512.63 <br />Grand Island, NE 688021692 <br />This notice was prepared and signed at IL , on this, <br />the <br />2015 3 :I7PM NE Secretary of State — UCC <br />15th day of January 2 0 15 . <br />Signature Covjj^4.--' <br />for G.J. CARTBRIJOUIS <br />Title <br />ACS' SBSE <br />(800) 829 -3903 <br />No. 9030 P. 2;'2 <br />24-0D -0008 <br />68 <br />{NOTE: Certlfiaete of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -488, 1971•- Z C.8.448) Form 660(Y)(c) (Rev. 2 -2004) <br />Pan 1 • Kept em RUMOR, Ofnce CAT. NO 60025X 1l <br />