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NE Sec of State - Robert R. Evnen <br />Filing Document #: 1912001436-1 Pages: 1 <br />Debtor Name: JOSHUA R SHERWOOD <br />Filing Date and Time: 12/27/2019 02:38 PM <br />201908159 <br />Form 668 (Y)(c) <br />F <br />(Rev. February 2004! <br />17505 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS/SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (800) 913-6050 <br />398198619 <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 gen in favor of the United States on a0 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 JOSHUA R SHERWOOD <br />Residence 201 WEST PLUM <br />DONIPHAN, NE 68832-0000 <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 shell, <br />on the day following such date, operate es a certificate of release as defined <br />in 'RC 0325(a). <br />Tax Period <br />Date of <br />LastDav for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Re <br />of Assessment <br />(a) <br />(b) <br />_c) <br />(4) <br />(e) <br />(f) <br />6672 <br />03/31/2018 <br />XXX -XX -1733 <br />09/30/2019 <br />10/30/2029 <br />15914.61 <br />6672 <br />06/30/2018 <br />XXX -XX -1733 <br />09/30/2019 <br />10/30/2029 <br />16299.31 <br />6672 <br />09/30/2018 <br />XXX -XX -1733 <br />09/30/2019 <br />10/30/2029 <br />17131.24 <br />6672 <br />12/31/2018 <br />XXX -XX -1733 <br />09/30/2019 <br />10/30/2029 <br />17011.34 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ <br />66356.50 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHLCAGO, IL on this, <br />the 17th day of December 2019 <br />Signature <br />1 <br />for COLBY SCHWAN <br />Title <br />REVENUE OFFICER <br />(402) 473-4671 <br />26-15-2722 <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. Rut, 71.466, 1971 - 2 C.B. 409) Form 668(Y)(t) (Rev. 2-2004! <br />Part 1 • Kept By Recording Office CAT. NO 60025X <br />