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Nov. 21.2013 19FM NE Secretary .f 'Stat. <br />Form 668 (Y)(c) <br />(Roy- February 20041 <br />110/4 <br />1 6 F. 2 <br />NF 5,0 of Stam -rola x Cole <br />Piling Document N: 1811001082-6 Pagos: 1 <br />Debtor Nave: DAVID F KEARY <br />Piling Dae sod Time: 11/21/20111 11:45 AM <br />Deportment of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />201807603 <br />Area; <br />SMALL H17SINs5B/SELF EMPLOYIID AREA #4 <br />Lien Unit Phone: (8o0) 913-6050 <br />T Serial Number <br />331756918 <br />For optional Use by Recording Office <br />As provided llly section 6321, 6322, and 6323 of she 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 its 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 DAVID P & H,AIDgE gIRBY <br />Residence 1189 R CAPITAL AVE <br />GRAND ISLAND, NE 6B801-3080 <br />IMPORTANT RELEASE tNFORMAT1ON: For each assessment listed below, <br />unless notice of the lien is reflled by the dais glean in column tel, this notice shall, <br />on the day following such da e, operate as a certificate of release as defined <br />in (RC 6325(a1. <br />Ta(. 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 />(b) <br />(c) <br />(d) <br />(e) <br />(9 <br />1040 <br />_ <br />12/31/2017 <br />XXX -XX -5243 <br />08/20/2016 <br />09/19/2028 <br />67991.52 <br />Placa of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ <br />67991.52 <br />Grand Island, NE 68902-1692 <br />This notice Was prepared and signed et CHICAGO, Its <br />the 02nd day of November 2018 <br />,'on this, <br />Signature <br />for G.J. TER -LOUIS <br />Title <br />ACS SB88E <br />(800) 829-3903 <br />24-00-0008 <br />(NOTE: Certlfioare al officer euchre tad by law to take acknowledgment is not essendal to the validity of Notice of Federal Try lien <br />Aev. Rut, 71-455, 1 97 1 - 2 C.B. 4091 Form 669(Y)(c) thee, 2-2004) <br />CAT. NO 60025X <br />Part 1 - kept By Leto/dies Office <br />