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10/05/2000 10:56 FAX 14024714429 NEBRASKA UCC <br />� <br />109 Department of the Treasury - internal Revenl <br />Form 668 (Y)(c) Notice of Federal Tax Lien <br />(Rev. August 19g71 <br />District Serial Number <br />MIDWEST 390039925 <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 JAMES A MOORE <br />Residence 712 N CLEBURN <br />GRAND ISLAND, NE 68801 -4247 <br />121002/002 <br />111111111111&.41111111111111111111111111111 <br />9900087892 Pes. t <br />MOORE JAMES R <br />Filed: 10105/2000 10 20 AM <br />r'u1 UPL1v,101 -00 VY t,aa.ui uu,y v <br />2OOOOS277 <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(x). <br />Tax Period Date of Last Day for unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refilling of Assessment <br />(a b (c ) (d e f) <br />1040 12/31/1998 280 -58 -2396 09/06/1999 10/06/2009 6198.78 <br />Place of Filing <br />Register of Deeds Total 9 <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI <br />the 26th day of September 2000 <br />Signature ent" i '� '� ,%% I Title ACS 39 -01 -0008 <br />for JEFFAY (800) 829 -3903 <br />6198.78 <br />, on this, <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.S. 409) Form 668(Y)(c) (Rev. 8.97) rilr\ <br />Part t - Kept By Recording Office CAT. No 60025X <br />