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09\1`212060 08:40 F1k 14024114429 NEBRASKA UCC <br />i <br />Form 669 (y)(c) 1Uy Department of the Treasury - Internal Revenue <br />(Rev. August 19971 MotiCe of Federal Tax Lien <br />District Serial Number <br />For <br />MIDWEST 390038246 <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 foibwing -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 MARTIN LIME <br />Residence PO BOX 1711 <br />GRAND ISLAND, NE 68802-1-711 <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 />an the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period <br />Kind of Tax <br />Ending <br />identifying Number <br />Assessment <br />Last Day for <br />Refiliog <br />a <br />b <br />(c <br />1040 <br />1040 <br />12/31/1995 <br />12/31/1996 <br />505 -35 -3256 <br />505 -35 -3256 <br />05/10/1999 <br />05/10/1999 <br />06/09/2009 <br />0611/09/2009 <br />Place of Filing <br />Register of Deeds <br />Hall PCROX 1692 <br />Grand Island, NE <br />This notice was prepared and signed at <br />the 06th day of <br />Signature <br />f or <br />September 2000 <br />0003/005 <br />I IIIIIC VIII +III! 11111 IIIII full !!Ir III <br />9Si00082072 P;s <br />MENDOZA MARTIN L <br />Filed: D9/ii/2000 03:29 pit <br />nal Use <br />200007511 <br />Unpaid Balance <br />of Assessment <br />583.80 <br />5337.44 <br />Total j $ <br />1 <br />E8802 -1692 5921.24 <br />MILWAUKEE, WI <br />Title ACS 39 -01 -0000 <br />(800) 829 -7650 <br />% wee; 1-eruTicats or officer authori2ed by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Pul. 71 -46e, 1971 - 2 C.B. 409) <br />Part 1 - Kept By Recording Office Form 668(T)(c) ;Rev. 8.97i <br />CAT. NO 60025X <br />, on this, <br />