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Form 668 CO(c) <br />(Rev. February 2004) <br />11874 <br />Department of the Treasury - Internal Revenue Service 2 018 0 4 6 <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSYNESS /SELF EMPLOYED AREA #6 <br />Lien Unit Phone:' (800) 913w6050 <br />Serial Number <br />314469918 <br />For Optional Use by Recording Office <br />N E <br />Sac <br />. <br />x.a <br />a John <br />A 0.1.1 <br />- <br />UCC [TL <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 />p oP rty and rights to <br />there is a lien in favor of the United States on all property <br />99 981 f3iz4 —z pgf; 1 <br />TRUELL TRUELL aarvEs H <br />property belonging to this taxpayer for the amount of these taxes, and <br />Flied: 07/19/2010 51:17 PIS <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer JAMES H TRUELL <br />Residence 903 W DIVISION ST <br />GRAND ISLAND, NE 68801 - 6451 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column is), 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 />Refil'mg <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) . <br />(f) <br />1040 <br />12/31/2014 <br />XXX -XX -6144 <br />04/09/2018 <br />05/09/2028 <br />5291.0. <br />• <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 5291.01 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />Jul,19. 2013 3:12FM NE Secretary of State — UCC <br />the <br />Signature <br />03rd day of July 2018 <br />for DANI TILE L PLATT <br />Part 1 - Kept By Recording Office <br />Title <br />REVENUE OFFICER <br />(402) 473 -4675 <br />No. 4-69 <br />26 -15 -2720 <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. Rol. 71 - 466, 1971 - 2 C.B. 409) <br />Form 668(Y)(0 (Rev. 2 -2004) n <br />CAT. NO 60025X // <br />43 <br />