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`-'02105633 <br />Pages: 1 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2107000005-1 <br />Debtor Name: CORDON P BLAKE <br />Filing Date and Time: 07/01/2021 11:02 AM <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />17489 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />433000121 <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 k remahu 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 GORDON P & ROSEMARY BLAKE <br />Residence 2455 LAMAR AVE <br />GRAND ISLAND, NE 68803-6233 <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 shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 8325(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 Day for <br />ReflUng <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />1040 <br />1040 <br />1040 <br />12/31/2017 <br />12/31/2018 <br />12/31/2019 <br />XXX -XX -0433 <br />XXX -XX -0433 <br />XXX -XX -0433 <br />07/23/2018 <br />11/18/2019 <br />04/19/2021 <br />08/22/2028 <br />12/18/2029 <br />05/19/2031 <br />187.25 <br />7410.20 <br />28027.93 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 35625.38 <br />CHICAGO, IL <br />This notice was prepared and signed at on this, <br />the 07th day of June 2021 <br />Signature <br />ez.ei <br />for DANIELLE L PLATT <br />Title <br />REVENUE OFFICER <br />(402) 473-4675 <br />26-14-4820 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment Is not essential to the validity of Notice of Federal Tex lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) <br />Form 668(Y)(c)1Rev.2.2004) <br />CAT. NO 60025X <br />Parc 1 - Kept By Recording Office <br />