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NE Sec of State - Roben B. Evnen <br />Filing Document #: 2212001044-8 Pages: 1 <br />Debtor Name: GERARDO ZEPEDA <br />Filing Date and Time: 12/29/2022 10:04 AM <br />202208886 <br />Form 668 (Y)(c) <br />(Rev. February 244) <br />17628 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #1 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />464470722 <br />For Optional Use by Recording Oftice <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 GERARDO ZEPEDA <br />Residence 703 W 16TH ST <br />GRAND ISLAND, NE 68801 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column lel, this notice shall, <br />on the day following 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 Day for <br />Refiling <br />(e) <br />Unpaid Balance <br />of Assessment <br />(1) <br />1040 <br />1040 <br />1040 <br />12/31/2017 <br />12/31/2018 <br />12/31/2019 <br />XXX -XX -5414 <br />XXX -XX -5414 <br />XXX -XX -5414 <br />07/11/2022 <br />12/06/2021 <br />12/06/2021 <br />08/10/2032 <br />01/05/2032 <br />01/05/2032 <br />6534.30 <br />5502.09 <br />431.54 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 12467.93 <br />This notice was prepared and signed at <br />CHICAGO, IL <br />the 16th day of December 2022 <br />, on this, <br />Signature <br />for M. DELUCA <br />Title <br />ACS SBSE <br />(800) 829-3903 <br />21-00-0008 <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, Rul. 71-456, 1971 - 2 C.B, 4091 <br />CAT. NO 6Q025x <br />Part t - Kept By Recording Office Form bbfl( !Rev. 1 <br />25x <br />