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State of Nebraska 7/30/2019 5:22:35 PM PAGE 4/007 Fax Server <br />NE Sec or State - Robert B Even <br />Filing Document 4: 1907001594-2 <br />Debtor Name THOMAS A WAGONER <br />F ihrig Date and T e 0713)00199? 45 AM <br />Pages 1 <br />201904473 <br />Farm 446 00(0 <br />17642 <br />Department of the Treasury - Intet-nal Revenue Service <br />Notice of Federal Tax Lien <br />Arear <br />SMALL T:1.333 3:33:ESS / SELF Et43?::0Y1.2) P.REA P 4 <br />1.ie51 Unit 0n5i :: E00) 829 -3903 <br />Sena? Nh_amber-• <br />363159819 <br />Oriti.-JiNat :.;:.-..:- byl;wc,o.r..,-;:r.,:i - c, tnci, <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 kir the amount of these taxes, and <br />additional penalties, interest, and costs that tray accrue. <br />Name of Taxpayer THOMAS A WAGONER <br />Fie-siclence 217 I-LEROWHEAD RD <br />GRAND ISLAND, NE ,'38-801. -752:3 <br />IMPORTANT RELEASE INFORMATION: For 0130h asses:It-nem listed ixauw, <br />uniss noucc, of the lien is rW3ifeal by t be +-Ira 1-.21 5:31,PEtn in G."1.,a,V,r. 7‘,..31, thit ildtkx.t tha3i. <br />00 -idle- day 'otrewing such dato,. operatt, as a cestificate of reitt:is.s as <br />in IFIC: 6325fal, <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d <br />Last Day for <br />Refiling <br />e <br />Unpaid alance <br />of Assessment <br />(f) <br />1040 <br />1040 <br />" • <br />12131/2008 <br />1.2/31/2017 <br />XXX -XX -0742 <br />XXX--XX--0742 <br />7/1.!3/2013 <br />07/23/2018 <br />08/14/2023 <br />08/22/2028 <br />11023.94 <br />464.25 <br />Piece of- Filing <br />Regia ter of. Deeda <br />kial.:1. F•O£1.:"_.,X 1 6 *.,142 -rota! <br />Grand Island, NX 68E02 -1-62 <br />$ i1488,19 <br />CHIC:AGO, IL <br />This notice was pfapariari end signed crt <br />05th v <br />the day of <br />2019. <br />, thIS. <br />Signature <br />c.)r 3.J. CARTER-- LOUIS <br />Tide <br />ACS SEISE <br />(S00) 829-3903 <br />24 - 00- o <br />Cortir.iczlto, of off,;( t;y. 155.7 Ile.konw11:4y-r,sr: ;e. nt:: eisc-nlial CO 9CC 5 1019-, f P.Infi;:u. 0wlf(Jorr:i ray. iao <br />Rev. f-luf. 7 •455. 1 ETC 2 C.K. 4.13; <br />Part I - Kept. By itt•tor3Ing 'Mkt <br />Foss 6633C0(c) (32tly. <br />CAT: 91C, (300;EtiX <br />