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Form 668 (Y)(c) <br />(Rev. February 2004) <br />Residence <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br />1040 <br />Place of Filing <br />the <br />Signature <br />Jan. 18. 2017 3:41FM •NE Secretary of State — UCC <br />3351 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA ff4 <br />Lien Unit Phone: (Doe) 829 -3903 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <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 WENDEL G FETTIG <br />1112 W 5TH ST <br />GRAND ISLAND, NE 68801 -4416 <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 date, operate as a certificate of release as defined <br />in IRC 6325(a)_ <br />Tax Period <br />Ending <br />(b) <br />12/31/20 <br />12/ <br />1 2/31/201 2 <br />This notice was prepared and signed et <br />Identifying Number <br />(c) <br />XXX -XX -6923 <br />XXX -XX -6923 <br />XXX -XX -6923 <br />22nd day of December 2016 <br />Date of <br />Assessment <br />(d) <br />07/04/2016 <br />04/18/2016 <br />04/18/2016 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />243020716 <br />Last Day for <br />Refing <br />(e) <br />08/03/2026 <br />05/18/2026 <br />05/18/2026 <br />Title <br />ACS SBSE <br />(800) 829--3903 <br />Part 1 - Kept By Recording office <br />Na. 9311 <br />201700406 <br />For Optional Use by Recording Office <br />44E Sit of Visit, Jahn R Gala . !IC[ FM <br />9917795535 -3 Pus, 1 <br />FETTIG WENDEL G <br />Filed: 01118/2017 12729 PM <br />Total $ <br />Unpaid Balance <br />of Assessment <br />(f) <br />4830.36 <br />1493.78 <br />2179.73 <br />8503.87 <br />CHICAGO, IL. , on this, <br />24 -00 -0008 <br />f or G.J. CARTER -LOUIS <br />(NOTE: Certificate of officer authorized by law to take acknowledgment Is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71466, 1971 - 2 C.B. 409) Form 660(Y)(c) (Rev. 2 - 2004) <br />CAT. NO 60026X <br />