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201907330 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 1911001169-3 Pages: 1 <br />Debtor Name: JOHN A REAL. <br />Filing Date and Time: 11/20/2019 01:50 PM <br />Form 666 (Y)(c) <br />/Mev. February 20041 <br />17505 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829-7650 <br />Serial Number <br />392229219 <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 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 JOHN A BEAL <br />Residence 200 E US HIGHWAY 34 APT 2060 <br />GRAND ISLAND, NE 68801-9717 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column fel, this notice shall, <br />on the day allowing such date, operate as a certificate of release as defined <br />in IRC 6325(a). <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 Dm for <br />Refiling <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />12/31/2009 <br />XXX -XX -2780 <br />04/23/2012 <br />05/23/2022 <br />6366.31 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 6366.31 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />Signature <br />12th day of November 2019 <br />for GRACE SANTACRUZ <br />Title <br />ACS W&I <br />(800) 829-7650 <br />14-00-0000 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the val. <br />nev. Rud. 71.466, 1971 - 2 C.B. 4091 <br />Part 1 - Kept By Recording Offke <br />of Notice of Federal Tax lien <br />Form 668(Y)(c) (Rev. 2-20041 <br />CAT. NO 60025% <br />