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05/11/001 11:45 FAX 14024714429 <br />NEBRASKA UCC <br />la 006/006 <br />This notice was prepared and signed at MILWAUKEE, WI <br />the 05th day of May 2001 <br />, on this, <br />Signature Title <br />ACS 39 -01 -0008 4 <br />for GALL -ER (800) 829 -3903 <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 -456, 1971 - 2 C.B. 409) 1 <br />Pare 2 - internal Revenue Service TDA Copy Form 668(Y)([) (Rev. 10 -00) } <br />CAT. NO 60025X <br />109 <br />Department of the Treasury - Internal Revenue <br />1111111111 <br />fi�1111111111111111111111111 <br />Forst 668 (Y)(c) <br />9901140773 P9s. 1 <br />Notice of Federal Tax Lien 6uGEWAGEN eRETT <br />Mev. October 2000) <br />FlSed: <br />05151r2JOt '0 :.S AM <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (80+0) 829 -3903 <br />390145821 <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 BRETT BUGENHAGEN <br />200104360 <br />Residence 3036'1/2 S LOCUST ST <br />GRAND ISLAND, NE 68801 -8866 <br />nnnn <br />TANT RELEASE INFORMATION: For each assessment listed below, <br />tice of the lien is refiled by the date given In column (e), this notice shall, <br />EiOnIORC <br />ay following such date, operate as a cartificate of release as defined <br />325(a). <br />Tax Period <br />Dat e of <br />last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />ldentifylng Number <br />Assessment <br />Refilling <br />of Assessment <br />a <br />b <br />c) <br />d <br />e <br />f <br />1040 <br />12/31/1994 <br />504 -86 -1550 <br />03/17/1997 <br />04/16/2007 <br />6499.46 <br />1040 <br />12/31/1995 <br />504 -86 -1550 <br />09/29/1997 <br />10/29/2007 <br />16648.69 <br />1040 <br />12/31/1996 <br />504 -86 -1550 <br />09/29/1997 <br />10/29/2007 <br />6753.81 <br />1040 <br />12/31/1997 <br />504 -86 -1550 <br />09/21/1998 <br />10/21/2008 <br />6900.99 <br />1040 <br />12/31/1998 <br />504 -86 -1550 <br />09/27/1999 <br />10/27/2009 <br />6269.97 <br />1040 <br />12/31/1999 <br />504 -86 -1550 <br />09/25/2000 <br />10/25/2010 <br />8153.34 <br />Place of Filing <br />Register of Deeds Total <br />$ <br />Hall POBOX 1692 <br />51226,46 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI <br />the 05th day of May 2001 <br />, on this, <br />Signature Title <br />ACS 39 -01 -0008 4 <br />for GALL -ER (800) 829 -3903 <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 -456, 1971 - 2 C.B. 409) 1 <br />Pare 2 - internal Revenue Service TDA Copy Form 668(Y)([) (Rev. 10 -00) } <br />CAT. NO 60025X <br />