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Nov, 18. 2015 J:(FM NE Secre.tary of Stag — UCC <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />5216 <br />Area: <br />SMALL BUSINESS /SETA:' EMPLOYED AREA #4 <br />Lien Unit Phone: (Boo) 629 -3903 <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 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 />Name of Taxpayer VONNIE WHITE <br />Residence <br />2565 W PLATTE RIVER DR <br />DONIPHAN, NE 68832 -9608 <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 />CIVP <br />CIVP <br />Place of Filing <br />Tax Period <br />Ending <br />(b) <br />12/31/2009 <br />03/31/2010 <br />Signature <br />f or G. J. CARTER -LOUIS <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax . Lien <br />identifying Number <br />(c) <br />XXX -XX -8857 <br />XXX -XX -8857 <br />the 2 9Ch day of October 2015 <br />C pv-dl ems+ <br />Serial Number <br />Date of <br />Assessrent <br />(d) <br />11/12/2012 <br />11/12/2012 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />183784415 <br />Last Day for <br />Refiling <br />(e) <br />12/12/2022 <br />12/12/2022 <br />Title <br />ACS SBSE <br />(800) 829 -3903 <br />No. 3656 F. 2/3 <br />201507954 <br />For Optional Use by Recording Office <br />NO Sac of SkaOt Jahn G Ga <br />9915764096 - 2 <br />WHITE VONNIE <br />Fi1ad: 11/1B/701E 01:59 PM <br />91 <br />Total $ <br />Unpaid Balance <br />of Assessment <br />(f) <br />This notice was prepared and signed at CHICAGO, IL <br />186,17 <br />24973.80 <br />25159.97 <br />, on this, <br />24-00-0008 <br />(1IOTEE: 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 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -2004) <br />Dxt 1 - Kant Rv Re,nrellno Affiro - • — . • — •• <br />