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9n7504136 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2507001085-0 Pages: 1 <br />Debtor Name: ERIC SMITH <br />Filing Date and Time: 07/29/2025 10:18 AM <br />3005 <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 <br />Serial Number <br />519143325 <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 ERIC SMITH <br />Residence 320 CAMPBELL AVE <br />DONIPHAN, NE 68832-9719 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the hen is refiled by the date given in column (el, this notice shall, <br />on the day following such de e, operate as a certificate of release as defined <br />in IRC 8325(a). <br />Tax Period <br />Date of <br />Last Daayy for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />identifying Number <br />Assessment <br />R�efiltng <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2008 <br />XXX-XX-5764 <br />07/02/2012 <br />08/01/2032 <br />40751.56 <br />1040 <br />12/31/2009 <br />XXX-XX-5764 <br />07/02/2012 <br />08/01/2032 <br />33872.56 <br />1040 <br />12/31/2010 <br />XXX-XX-5764 <br />07/02/2012 <br />08/01/2032 <br />7730.18 <br />1040 <br />12/31/2011 <br />XXX-XX-5764 <br />06/18/2012 <br />07/18/2032 <br />14188.68 <br />1040 <br />12/31/2016 <br />XXX-XX-5764 <br />04/30/2018 <br />05/30/2028 <br />125284.19 <br />1040 <br />12/31/2017 <br />XXX-XX-5764 <br />07/09/2018 <br />08/08/2028 <br />113735.36 <br />1040 <br />12/31/2018 <br />XXX-XX-5764 <br />11/18/2019 <br />12/18/2029 <br />6278.61 <br />1040 <br />12/31/2019 <br />XXX-XX-5764 <br />12/13/2021 <br />01/12/2032 <br />10842.96 <br />1040 <br />12/31/2020 <br />XXX-XX-5764 <br />12/20/2021 <br />01/19/2032 <br />228.11 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 352912.21 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the Olst day of July 2025 <br />Signature i / ��,,,,,,/' ACS SBSE <br />for D.J. RAMSEY �"` Zl (800) 829-3903 <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. 71-466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-2004) <br />Part 1 - Kept By Recording Office CAT. NO 60026X <br />24-00-0008 <br />