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Form 668 (Y)(c) <br />041 <br />(Rev. February 20041 <br />11874 <br />Department of the Treasury - Internal Revenue Service _ <br />Notice of Federal Tax Lien 20180588 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (900) 913 - 6050 <br />Serial Number <br />321611018 <br />For Optional Use by Recording Office <br />so. .f SAM.. Jahn P Gale - IJeC e <br />pt sac cf SAM.. John P Gale - UGL e <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 />I <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 />P9s: 1 <br />9916819104 -3 <br />CROSBY SHANNON <br />Filed: 9910712016 11:54 fl <br />Name of Taxpayer SHANNON CROSBY <br />Residence 3763 W CAPITAL AVE APT N313 <br />GRAND ISLAND, NE 68803 -1307 <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 />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(1 <br />(d) <br />(e) <br />(f) <br />6672 <br />09/30 <br />C"- r r- r- r- r- r- r- <br />4444 d V NPd+ NV <br />C CV a d N+ dp ev <br />?d <br />• 1 II t i l l <br />a <br />08/13/2018 <br />09/12/2028 <br />7353.70 <br />6672 <br />12/31 <br />08/13/2018 <br />09/12/2028 <br />8508.12 <br />6672 <br />03/31 <br />08/13/2018 <br />09/12/2028 <br />9243.69 ' <br />6672 <br />06/30 <br />08/13/2018 <br />09/12/2028 <br />9989.71 <br />6672 <br />09/30 <br />08/13/2018 <br />09/12/2028 <br />11092.43 <br />6672 <br />12/31 <br />08/13/2018 <br />09/12/2028 <br />9600.83 <br />6672 <br />03/31 <br />08/13/2018 <br />09/12/2028 <br />9167.86 <br />6672 <br />06/30 <br />08/13/2018 <br />09/12/2028 <br />8597.53 <br />• <br />• <br />Place of Filing - • <br />Register. of Deeds <br />Hall POBOX 1692 Total <br />$ 73553.87 <br />Grand Island, NE 68802 -1692 <br />S,p, 7.20118 40FM NE Secretary c)f ;State <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the 28th day of August 2018 <br />Signature <br />for COLBX /SCHWAN <br />Title <br />REVENUE OFFICER <br />(402) 473 -4671 <br />Nu, 0912 F. <br />26 -15 -2722 <br />(NOTE: Certificete of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax Ilen <br />Rev. Rule 71-466, 1971 2 C.B. 409) Form 666(Y)(c) (Rev. 2 -2004) <br />Pert I - Kent 6v Recording Office <br />