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Form 66e1`) <br />(Rev. February 2004) <br />5216 - <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA. #3 <br />Lien Unit Phone: (Boo) 913 - 6050 <br />Serial Number <br />200105516 <br />For Optional Ube by Recording Office <br />Ni Sac of 64 + John a Salo - UCC FIL <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 />I <br />there is a lien in favor of the United States on all property and rights to <br />rope belonging to this <br />property gr g taxpayer for the amount of these taxes and <br />additional penalties, interest, and costs that may accrue. <br />9916789561 -6 P9a: 1 <br />216 09:66 AM <br />E 03/eOr ® <br />cpR <br />Name of Taxpayer TROY E CARSWELL <br />Residence 3739 NORSEMAN AVE <br />GRAND ISLAND, NE 68803 <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 />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />dumber <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />( <br />(d) <br />(e) <br />(I) <br />6672 <br />12/31 <br />cn 1.0 VI Un in iri un <br />CD m0 m00m <br />0 0 0 0 0 0 0 <br />y H H H H H H H <br />IIIIIII <br />5 5 i 51 <br />11/09/2009 <br />12/09/2019 <br />27124.80 <br />6672 <br />03/31 <br />11/09/2009 <br />12/09/2019 <br />102328.58 <br />6672 <br />06/30 <br />11/09/2009 <br />12/09/2019 <br />93682.92 <br />6672 <br />09/30 <br />11/09/2009 <br />12/09/2019 <br />87850.86 <br />6672 <br />12/31 <br />11/09/2009 <br />12/09 /2019 <br />56676.45 <br />6672 <br />03/31 <br />05/31/2010 <br />06/30/2020 <br />49970.19 <br />6672 <br />06/30 <br />05/31/2010 <br />06/30/2020 <br />58831.98 <br />1 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 476465.76 <br />.Grand Island, NE 68802 -1692 <br />Mar. 3. 2516 3:46FM NE Secretary of State — UCC <br />N0.5353 <br />This notice was prepared and signed at CHICA GO, I1 ' , on this, <br />the <br />23rd day of February 2016 <br />Signature <br />for MS. C.L. LITTLE <br />Part 1 - Kent By Recording Office <br />Title <br />REVENUE OFFICER <br />(352) 291 -2815 <br />23-06-3503 <br />N1) <br />Form 66B(Y)(c) (Rev. 2 - 2004) <br />CAT. NO 60026X <br />(NOTE: Certificate of officer authorized by law to take acknowledgment ie not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466. 1971 - 2 C.B. 409) <br />