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State of Nebraska 6/12/2019 3:49:20 PM PAGE 3/004 Fax Server <br />NE Sec of State - Robert B Evnen <br />Filing Document #: 1906000495-6 Pages: 1 <br />Debtor Name. HECTOR M RUBIO <br />Filing Date and Tune 06112/2019 09 35 AM <br />201903400 <br />174;19 <br />Deparunest of the Treasury - infernal ties/dr-toe Service <br />Form 6B (Y)() <br />Notice of Federal Tax Lien <br />Arad:: <br />Xr4PI,OYF.F.) ARCA <br />Lien 13 0 ) 29-• 3 9o3 <br />Serial 1\hirnUer <br />3622E3 19 <br />FoOpionIUZ,,f; <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notke 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 thi5 taxpayer for the amount of these taxes, and <br />4dditiondl penal(ies, in(erest, and costs that may accrue. <br />Narna of TZIX payer HECTOR & MARIA L., &URIC <br />Re„sitertOO <br />4204 W CAPITAL AVE <br />GRAND ISLAND, NE 68803-1411 <br />IMPORTANT RELEASE INFORMATION: FC,f each assessment tisted <br />',Mess ounce of the ;:an is refasrl by the data givan in ccilenn fc), thiS nOtice Shall, <br />on the day following such date, Operate es a ceficata of re3ease as defined <br />in tiC 25t,). <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(h) <br />Identifying Number <br />(t) <br />Date of <br />Assessment <br />(4) <br />N <br />Last Day for <br />Refiling- <br />(e) <br />Unpaid Balance <br />of Assessment <br />UL ------- <br />14728.22 <br />1040 <br />12/3112016 <br />XXX -XX --9833 <br />08/2(112018 <br />09/1912028 <br />Plar:4:i of Filing <br />Register of De's <br />Hall POBOX 1692 7-(ita <br />Grand island, NE 688-02-1.692 <br />$ 1472£f.22 <br />This notice was prepareci and signed at CAGO <br />the <br />04th clay o- June <br />3 <br />2019 <br />, On this, <br />b„...„-1 <br />Title <br />ACS sp3.8.3 <br />Stgrtatore <br />(600) i329-3903 <br />for G.J. CARTER -LOUIS <br />24-00-0008 <br />-NOTE: f,:Viifiei,AZe, ;ay., to U,ke ess: tn viiy ot NOtiCEI of ti:d€,43, Tax ,iF:Ct <br />Rok. 71-46,3. 19'71 - 2 Ct 40.1 <br />Form 1568(Y)(e) iRev. .:20f..44, <br />CATao(5f.iiiiiiZtzX <br />Part t Kept Ely R.Koreiittg Offi4e. <br />