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Ub <br />Form 668 (Y)(c) <br />(Flew. February 2004) <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (800) 913 -6050 <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 Tien 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 DAVID L & NIKKI CAUDILL <br />Residence <br />the <br />Oct. 24. 2017 2 :43F1 NE Secretary of State — UCC <br />11874 <br />1111 HALL ST <br />GRAND ISLAND, NE 68801-8181 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column le), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br />1040 <br />Place of Filing <br />for PATR <br />Tax Period <br />Ending <br />(b) <br />12/31/2014 <br />12/31/2015 <br />12/31/2016 <br />Identifying Number <br />(c) <br />XXX —XX -4 682 <br />XXX -XX -4682 <br />XXX -XX -4682 <br />This notice was prepared and signed at CHICAGO IL , on this, <br />Signature <br />Register of Deeds <br />Hall ROBOX 1692 <br />Grand Island, NE 68802 -1692 <br />12th day of October <br />J KELLOGG <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien 201707 2 3 0 <br />2017 <br />Serial Number <br />Date of <br />Assessment <br />(d) <br />02/15/2016 <br />02/27/2017 <br />07/03/2017 <br />292215417 <br />Last Day for <br />Refihng <br />(e) <br />03/17/2026 <br />03/29/2027 <br />08/02/2027 <br />Title <br />REVENUE OFFICER <br />(308) 663 -6003 <br />Nc, 2 '3E7 F. 2/2 <br />For Optional Use by Recording Office <br />NE s.o s f L4.ta John fl Gala - UCC ETL <br />I <br />991780048 -0 P <br />CPUOILL DRVID L <br />Filed; 10/2412017 11:43 Rn <br />Total $ <br />Unpaid Balance <br />of Assessment. <br />(f) <br />19055.79 <br />2902.58 <br />1217.16 <br />23175.53 <br />26 -15 -2724 <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 />Part t - Kept a Recording Office Form 668 c (Rev. n7gy ) <br />Y r-ot ran anm�x , 1 <br />