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00 <br />Jun. 18. 2013 3:42PM NE Secretary of 'State — UCC <br />form 668 (Y)(c) <br />(Rev. Februsry 2004) <br />Area: <br />WAGE F. INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829 - 7650 <br />Residence <br />Kind of Tax <br />(a) <br />1040 <br />Place of Filing . <br />This notice was prepared and signed at <br />the <br />Signature <br />Tax Period <br />Ending <br />(b) <br />11874 <br />12/31/2008 <br />07th day of June , 2018 <br />for GRAC ANTACRUZ <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <br />311159718 <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 DANA J & PAMELA L PETERSON DECD <br />1010 N EDDY ST <br />GRAND ISLAND, NE 68801 --4057 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is reified 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 IRO 6325(a). <br />Identifying Number <br />(c) <br />XXX - XX- 4029 <br />Date of <br />Assessment <br />(d) <br />08/27/2012 <br />Register of Deeds <br />}a11 POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />CHICAGO, IL <br />Last Day for <br />Refiling <br />(e) <br />09/26/2022 <br />Title <br />ACS W &I <br />(800) 829 -7650 <br />For Optional Use by Recording Office <br />Total $ <br />No. 4712 <br />NA Sac of 1lM4. Jvhn A 6A1• - U[c FTL <br />991 9B13863 -5 <br />Pas: 1 <br />PETERSON DANA J <br />Filed: 06119/2018 10:41 AM <br />201803909 <br />Unpaid Balance <br />of Assessment <br />(0 <br />47691.44 <br />47691.44 <br />, on this, <br />14 -00 -0000 <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) r___ x'tor",_ +n_.. �nnn <br />A� <br />