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D 6. 2018 46FM NE Secretary :f State <br />20180'78nn <br />N o. 14 ,�i 9 `. 6 <br />NE Sec of Siete -John A. Gale <br />Filing Document tr 1812000331-1 Pages; 1 <br />DOW Name: THEODORE 7 ROBB <br />Filing Dale and Tim:12R16+201010:74 AM <br />Form 668 (Y)(c) <br />(pew, February 2004) <br />11874 <br />Deportment of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA $4 <br />Lien Unit Phone: (aoo) a25-3903 <br />Serial Number <br />334794516 <br />For Optional Use by Recording Office <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (Including Interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a demand for Partnetlt of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the linked States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Nerve of Taxpayer THEODORE J ROBB <br />Residence 3740 S HWY 281 <br />GRAND ISLAND, NE 68803 <br />IMPORTANT RELEASE INFORMATIONt For each aeaesament Hated beidw. <br />unless notice of the lien is refiled by the date given in column lel, thie notice shah, <br />on the day following such date, operate as a certificate of releece as defined <br />in IRC 8325(a), <br />• <br />Klatt of Tax <br />(a) <br />Tax Period <br />Ending <br />5b) <br />identifying Number <br />(C) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refllng <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f? <br />1040 <br />1040 <br />12/31/2015 <br />12/31/2016 <br />XXX -XX -1425 <br />XXX -XX -1425 <br />04/02/2018 <br />11/20/2017 <br />05/02/2028 <br />12/20/2027 <br />9241.30 <br />24445.60 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, SIB 68s02-1692 <br />$ 33686.90 <br />This notice was prepared and signed et CHICAGO, IL , on this, <br />the 23rd day of November 2018 <br />Signature <br />Al S99E 24-00-,0008 <br />for G.J. TER -LOUIS (800) 829-3903 <br />(NOTE: CerdtIcem o1 offic®t authorized by law to telco acknowledpreent i= not essential to Itie validity of Notice 01 Federal Tax lien <br />Rev, Rul. 71.088, 1971 2 C.B. aO9) <br />Fart 1 - ICmt BJr keeordlnQ Mike CAT. <br />661411 ) (Rev. 2-2064) <br />CAT. NO 60025x <br />