Laserfiche WebLink
Fornl 668 (Y)(c) <br />(Rev. February 2004) <br />5216 <br />Department of the Treasury - Internal Revenue Service . 2 U 1 L s r � c� 1 ( <br />V V Fr <br />Notice of Federal Tax Lien <br />Area: - <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (Roo) 829 - 7650 <br />Serial Number <br />206356916 <br />For Optional Use by Recording Office <br />NE See of State John R Gale - UCC FTL <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 />1111111 <br />- <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 />9916772055 <br />—> P9s: <br />1 <br />property belonging to this taxpayer for the amount of these taxes, and <br />BURSON SANDRA L <br />additional penalties, interest, and costs that may accrue. <br />Filed 04/13l201E 01:59 PM <br />Name of Taxpayer SANDRA L BURSON <br />Residence 14425 S BUFFALO RD <br />DONIPI -IAN, NE 68832- 9612 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (a), 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 />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2010 <br />XXX -XX -2999 <br />06/18/2012 <br />07/18/2022 <br />394 <br />Place of Filing • <br />Register of Deeds <br />Hall POBOX 1692 . Total <br />$ 3945.51 <br />Grand Island, NE 68802 -1692 <br />Apr. 13. 2016. 3:36PV -NE Secretary of State — UCC <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the : Olst• day of April 2016 <br />Signature <br />for GRACE SANTACRUZ <br />Title <br />• ACS W &I <br />(600) 629 -7650 <br />Nc.6068 K 2/3 • <br />14 -00 -0000 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is riot essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Part t - Kept By Recording Office Form 669(1C)(c) (Rev. '004) <br />