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Sep. 7, 201O 9:40PM NE Secretary ..t State <br />Form 668 (Y)(c) <br />(Rev_ February 2004) <br />Residence <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br />1040 <br />Place of Filing <br />Signature <br />for G.J. <br />Tax Period <br />Ending <br />(b) <br />11874 <br />Area: <br />SMALL, BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829 - 3903 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <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 MICHELLE M MITCHELL <br />706 CHURCH RD <br />GRAND ISLAND, NE 68801 -7184 <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 />on the day following such date, operate as a certificate of release as defined <br />In IRC 6325(a). <br />12/31/2010 <br />12/31/2011 <br />12/31/2012 <br />TER -LOUIS <br />Identifying Number <br />(c) <br />the 27th day of August 2018 <br />XXX -XX -4050 <br />XXX -XX -4050 <br />XXX -XX -4050 <br />Date of <br />Assessment <br />(d) <br />07/08/2013 <br />07/22/2013 <br />07/29/2013 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />321361618 <br />Last Day for <br />Refing <br />(e) <br />08/07/2023 <br />08/21/2023 <br />08/28/2023 <br />Title <br />ACS SBSE <br />(800) 829 -3903 <br />NE 5 es stale John A Gale <br />99183191®29 <br />MITCHELL M CHELLE M <br />Fllad: 09 !07!2018 11 :54 AM <br />Total $ <br />Nc. (1912 <br />201805883 <br />For Optional Use by Recording Office <br />(f) <br />- ucc cry <br />P9s 1 <br />Unpaid Balance <br />of Assessment <br />9394.59 <br />16380.58 <br />2274.66 <br />28049.83 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />24 -00 -0008 <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) Form 668(Y)(c) (Rev. 2 -2004) <br />Part I - Kant Ay Rornrrlino CIFflr. - - — - <br />