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Form 668 (Y)(c) <br />(Rev. February 2004) <br />14742 <br />Department of the Treasury - internal Revenue Service 20160703 <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />231995016 <br />For Optional Use by Recording Office <br />H E Sae of Seta Jahn A G. a UGC ETL <br />M 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 trade <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 />9916781577 <br />-5 <br />Pg$ <br />9 <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, Interest, and costs that may accrue. <br />Filed: 16 08:10 PM <br />Name of Taxpayer WARREN a KIRSH <br />Residence 3886 MONTEGO DR <br />H'ONTINGTN BCH, CA 92649 -20 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the ben 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 />Identifying lumber <br />Assessment <br />Renting <br />of Assessment <br />(a) <br />( <br />(d) <br />(e) <br />(f) <br />6672 <br />03/31 <br />Ul u> > n ui 1n 1n In Un Un Ln Un ul <br />117 l° QD VD wa UD VD <br />(1 Mot on on MMon!f MmM <br />1 1 1 1 1 1 11 1 1 1 1 1 <br />000000000000 <br />08/29/2016 <br />09/28/2026 <br />4996.62 <br />6672 <br />06/3C <br />08/29/2016 <br />09/28/2026 <br />11485.99 <br />6672 <br />09/3C <br />08/29/2016 <br />09/28/2026 <br />15800.32 <br />6672 <br />12/31 <br />08/29/2016 <br />09/28/2026 <br />16788.29 <br />6672 <br />03/31 <br />08/29/2016 <br />09/28/2026 <br />17589.01 <br />6672 <br />06/30 <br />08/29/2016 <br />09/28/2026 <br />14390.34 <br />6672 <br />09/30 <br />08/29/2016 <br />09/28/2026 <br />13871,82 <br />6672 <br />12/31 <br />08/29/2016 <br />09/28/2026 <br />13008.22 <br />6672 <br />03/31 <br />08/29/2016 <br />09/28/2026 <br />10910.23 <br />6672 <br />06/30 <br />08/29/2016 <br />09/28/2026 <br />9345.97 <br />6672 <br />09/30 <br />08/29/2016 <br />09/28/2026 <br />9155.99 <br />6672 <br />12/31 <br />08/29/2016 <br />09/28/2026 <br />8125.29 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 145468.09 <br />Grand Island, NE 68802 -1692 <br />Oct. 21. 2816 3:59F'M NE Secretary of State — UCC <br />Nc. 8491 F. 4/5 <br />This notice was prepared and signed at CHICAGO IL , on this, <br />the <br />Signature <br />29th day of September 2016 <br />for DANIELLE L PLATT <br />Part 1 - Kept By Recording Office <br />Title <br />REVENUE OFFICER <br />(402) 473 -4675 <br />24 -06 -2720 <br />(WOTE: Certificate of officer authorized by law to teke acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Form 668(10(e) (Rev. 2 -2004) <br />CAT. NO 60025X <br />