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State of Nebraska 6/14/2019 3:53:49 PM PAGE 4/008 Fax Server <br />NE Stc orStatc - Krr/xrtB Evnen <br />Filing Document #: 1906000650-1 Pages. 1 <br />Debtor Name- WILLIAM! GALLES <br />Fhrrg Datc and Tan, 06/14/2019 10 40 AM <br />201903462 <br />17489 <br />F01111 668 00(t) <br />Doparlment co The Tre•nsury - Internai Revenigl !.;.:1-fsvice <br />Notice of Federal Tax Lien <br />Ar <br />SMALL BV:-.1):NBS8,15.11'11.,F IiMPLOYBD AF.t,.A. 14 <br />Unir. Phone, (800) 132 .9 c)3 <br />Serial Number <br />361.66:1619 <br />For ,:),prion:al k/Sc: Pn,":;;ocd;rn:; <br />Utr- <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 as.sessed 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 or 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 :nay accrue. <br />Narnf: of Taxpayer <br />Residence: <br />3 S BliADY BEND RD <br />GRAND ISLAND, NE 6'8801 - 8470 <br />41401111111106. <br />IMPORTANT RELEASE INFORMATION: For- each assegg'mon-t i.it;ted <br />iii.; lien it; leftled by ti/i! date SIZVQ-11 ttoiurnel jp,), ;hit:rico i!1/3i. <br />tno Gay icglowing such eia,,t.e% cperat(.; OS ace,ftific?..;te reteta-!. as defined <br />n IRC <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />1.040 <br />1040 <br />12/3 1. / 2 0 1.4 <br />12/31/201F <br />Identifying Number <br />(c) <br />XXX- XX -3304 <br />XXX -XX- 3 304 <br />Date of <br />Assessment <br />(d) <br />La.st Day for <br />Refiltng <br />(e) <br />Unpaid Balance <br />Asxessment <br />(f) <br />11/23/2015 <br />1.:1/14/2016 <br />12/23/2025 <br />12/1.4/2026 <br />27£3.:13 .13 <br />8365..08 <br />Piaci:: of Filinn <br />Register of Deeds <br />Hala POPO): 1492 <br />Grand Island, NE 68802-1692 <br />36198.21 <br />1 <br />ThCHICAGO, IL <br />it,: 156c:el Was prepared and signed at on <br />316it dayof May <br />the <br />Sigrozure <br />L15//_ <br />1-- <br />(I, <br />A44 <br />for G. J. CARTER -LOUIS <br />2019 <br />.ACS SBSE 24-00-0008 <br />829-3903 <br />oft,. -:et b. to:, IC, 1.101 t1:58t•ntitZt tz,e $"ecu?..“3.1 'rex <br />fli, t,l. 71-4511. 1;471 <br />Form 6613(Y)(r.) <br />No ci0f_12/3.5( <br />Part - Kevc By Raresedittsg:Offirr- <br />