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Form 668 (Y)(c) <br />(Rev. February 2004) <br />11874 <br />Department of the Treasury - Internal Revenue Service 201703 <br />Not of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829 -3903 <br />Serial Number <br />263361117 <br />For Optional Use by Recording Office <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />NE PM of Slake John A bale - UCC <br />FTL <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 />111 <br />1 <br />property belonging to this taxpayer for the amount of these taxes, and <br />9917793277 <br />-5 <br />- <br />Pss: <br />1 <br />additional penakies, interest, and costs that may accrue. <br />PANKoNIN PAUL <br />Filed: 03/09/2017 01:58 PM <br />Name of Taxpayer PAUL & JESSICA PANKONIN <br />Residence 1016 PLEASANT VIEW DR <br />GRAND ISLAND, NE 68801 -8022 <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 !RC 6325(a)_ <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 />Kerning <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2015 <br />XXX -XX -4006 <br />07/18/2016 <br />08/17/2026 <br />59126.84 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 59126.84 <br />Grand Island, NE 68802 - 1692 <br />Jun, 9. 2017 3:00PM NE Secretary of State — UCC <br />No. 1018 P. 2 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the 23rd day of May 2017 <br />Signature <br />f or G.J. GARTER -LOUIS <br />Title <br />ACS SBSE <br />(800) 829 -3903 <br />24 -00 -0008 <br />874 <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. 409) <br />AT . NO NO <br />Form 669( 2.2004) <br />( <br />Part 1 - Kept By ttecording Office CAT. 60025X <br />