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Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829 -3903 <br />Serial Number <br />254950017 <br />For Optional Use by Recording Office <br />,� gist• 11962h , A 6e/a �� cTL ma <br />I <br />P,ae <br />9ai7 g Fsi•1e 312 1145 API <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 property belonging to this taxpayer for the amount of these taxes, and <br />additional enalties, interest, and costs that m accrue. p <br />Name of Taxpayer MARTIN FLEMING <br />Residence 363.9 CURRAN AVE APT 4 <br />GRAND ISLAND, NE 68803 -1242 <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(2), <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 />Reining <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2010 <br />XXX -XX -4843 <br />04/18/2011 <br />05/18/2021 <br />1707.76 <br />1040 <br />12/31/2012 <br />XXX -XX -4843 <br />04/08/2013 <br />05/08/2023 <br />114.06 <br />1040 <br />12/31/2013 <br />XXX -XX -4843 <br />06/02/2014 <br />07/02/2024 <br />13497.39 <br />1040 <br />12/31/2014 <br />XXX -XX -4843 <br />01/04/2016 <br />02/03/2026 <br />2651.42 <br />1040 <br />12/31/2015 <br />XXX -XX -4843 <br />11/28/2016 <br />12/28/2026 <br />9363.45 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 27334.08 <br />Grand Island, NE 68802 -1692 <br />Apr, 21. 2017 09PM <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />the 30t h day of March 2017 <br />Signature <br />11874 <br />for G.J. (4'tRTER-LOUIS <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Title <br />ACS SEISE <br />(800) 829 -3903 <br />No, 3854 F. 2/5 <br />201702575 <br />This notice was prepared and signed at CHICAGO, IL , on this, . <br />24 -00 -0008 <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. 71 -466, 1971 - 2 C.B. 4-09) \\ <br />Recor By ding Office Form 668(lf )CAT. NO v. 025 41 <br />Part 1 - Kept B <br />CAT. NO 60026X <br />