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Form 668 c <br />(Y)(c) <br />(Rev. February 2004) <br />5216 • <br />Department of the Treasury - Internal Revenue Service 201505905 <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (000) 829 -3903 <br />Serial Number <br />171577115 <br />For Optional Use by Recording Office <br />no src of <br />9915760097 <br />Filed 0 e 11 2 01 2o <br />tiled: ©er2e�a <br />slot. J =ti.. <br />- <br />®16 <br />R <br />02:15 <br />Ga,. <br />- uCC <br />Pa <br />FT. <br />Pes : <br />1 <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 Iiability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />property gin g xpayer for the amount of these taxes and <br />roper belonging to this taxpayer <br />additional penalties, Interest, and costs that may accrue. <br />Name of Taxpayer FRANCISCO J GOVEA <br />Residence 1409 •E 5TH ST <br />GRAND ISLAND, NE 68801 -2909 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed 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 />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 Day for <br />Reflling <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />1040 <br />1040 <br />12/31/2000 <br />12/31/2001 <br />12/31/2002 <br />XXX -XX -5296 <br />XXX -XX -5296 <br />XXX -XX -5296 <br />04/24/2006 <br />04/24/2006 <br />04/24/2006 <br />05/24/2016 <br />05/24/2016 <br />05/24/2016 <br />47530.50 <br />27776.05 <br />39038.75 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 114345.30 <br />Aug, 28. 2015 2:56FM NE Secretary o f State — UCC <br />This notice was prepared and signed at CHICAGO, . IL , on this, <br />the <br />f or G.J. CARTER-LOUIS <br />Signature <br />13th day of August <br />2015 <br />, • <br />Title <br />ACS SBSE <br />(800) 829 -3903 <br />N0. 2409 P. 2/2 <br />24 -00 -0008 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment Is not essential to the validity of Nodes of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Part 1 Kept By Recording Office Form 668(Y)(c) (Rev. 2 -2004) <br />(AT. NO 60075X <br />