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04/06 /2001 1 <br />14:11 FAX 14024'14429 N <br />NEBRASKA UCC Q <br />Q003/005 <br />a <br />lIIII I <br />IIIII I <br />IIII I <br />IIIII 1 <br />1111! I <br />Ill10 9 <br />ll I <br />IPI1 1 <br />1 <br />ll <br />Department of the Treasury - Internal Revenue <br />Form 668 (Y)(c) 990113LVIN Psas , <br />Notice of Federal Tax Lien GRAY 0410512001 03-45 PM <br />(Re.. October 2000) <br />cr., nminnml Use by Recordina Office <br />Area: �" w..... ,. .. <br />WAGE & INVESTMENT AREA #5 390143629 <br />Lien Unit Phone: (8 00) 829 -7650 <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 <br />Residence 604 E SUTHERLAND APT 3 BOX 15 <br />GRAND ISLAND, NE 68801 -7761 <br />200102968 <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 dater operate as a certificate of release as defined <br />in IRC 03251a). <br />Tax Period Date of Last Day for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />a b c d e) _ <br />1040 12/31/1996 523 -23 -4268 04/10/2000 05/10/2010 6983.11 <br />1040 12/31/1997 523 -23 -4268 04/10/2000 05/10/2010 1855.02 <br />1040 12/31/1998 523 -23 -4268 05/24/1999 06/23/2009 432.90 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE <br />This notice was prepared and signed at <br />the 29th day of Marcz <br />Signature <br />68802 -1692 <br />2001 <br />MILWAUKEE, WI <br />ACS <br />Total 1$ <br />9271.03 <br />, on this, <br />39 -01 -0000 <br />for u D EPPL 4- �� 1 (800) 829-7650 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validlty of Notice of Federal Tax lien <br />Rev. Rul. 71 -486, 1971 - 2 C.B. 4091 Form 66e(Y)(e) [Rev. 10 -00) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE <br />This notice was prepared and signed at <br />the 29th day of Marcz <br />Signature <br />68802 -1692 <br />2001 <br />MILWAUKEE, WI <br />ACS <br />Total 1$ <br />9271.03 <br />, on this, <br />39 -01 -0000 <br />for u D EPPL 4- �� 1 (800) 829-7650 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validlty of Notice of Federal Tax lien <br />Rev. Rul. 71 -486, 1971 - 2 C.B. 4091 Form 66e(Y)(e) [Rev. 10 -00) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />