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NOTICE OF FEDERAL TAX LIEN REF ILING Serial ID: 212754416 Notice filed At: Hall New T? Name: New TIN: New Address: a A''-e5 Cii,-JAN,r" Signa for PATRICK G ELLSWCRTH DATE: 05/12/2016 (402) 233 - 7400 Title: REVENUE OFFICER Area: SMALL BUSINESS /SELF EMPLOYED AREA #4 Lien Unit Phone: (800) 913 -6050 As provided by section 632t, 6322, and 6323 of the. Internal Revenue Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the following - named taxpayer. We have made a demand for payment of this liability, but it remains unpaid. Therefore, there is a lien in favor of the United States on all property and rights to property belonging to this taxpayer for the amount of these taxes, and additional penalties, interest, and costs that may accrue. Name of Taxpayer JERRY L & CAROLE L DENTON Residence Kind of Tax (a) 1040 Jun. 1 2016 3:16PM NE Secretary of State — UCC ' No. 6736 P. 2;3 4` ,,,,,G — - — REFILL,IJ i'vllt,c, --- xr,r s.unD NOTICE * ** REFLur..0 1VOTLLr.: ^ ** 5216 REFILE REFILE Department of the Treasury - Internal Revenue Service 201603463" Form 668 -F (Rev. February 2004) 205 S CEDAR ST GRAND ISLAND, NE 68801 -6501 IMPORTANT RELEASE INFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column (e), this notice shall, on the day following such date, operate as a certificate of release as defined inIRC 632i(e)* NOT APPLICABLE TO A REFILED NOTICE * ** Place of Filing Tax Period Ending (b) 12/31/2004 This notice was prepared and signed at the Signature . 27th day of March for REGINA OWENS Identifying Number (c) XXX-XX-3 010 Notice of Federal Tax Lien Register of Deeds Hall POBOX 1692 Grand Island, NE 68802 -1692 2007 ReCordede 04/0S/2007 '9907504250.9 14:25 200702602 Serial Number Date of Assessment (d) 06/05/2006 354042607 Title ACS SESE 24 - 0008 Last Day for Reining (e) 07/05/2026 F Optional Use by Recording Office NE Sec of 54 a4e Jahn R 6a UCC PREP' 1111111 9916774820 -3 Pgs': DENTON JERRY L Filed: 06/03/2016 01:13 PM Total Unpaid Balance of Assessment (0 14758.91 14758.91 CHICAGO, IL , on this, (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev. Rel. 71 -466, 1971 - 2 G,B. 409) Part 1 - Kept By Recording Office Form 668 - (Rev. 2- 2004) CAT. NO 60025X .