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3 <br />02/04/2004 12:18 FAX 14024714429 NEBRASKA UCC Q 004/004 <br />5169 <br />Form ddb (Y)(c) Department of the Treasury - Internal Revenue Service <br />jRev. October 2000) Notice of Federal Tax Lien <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #$9 <br />Lien Unit Phone: (651) 312 -8080 <br />153799304 <br />w Svc of s..+. - ucc FT <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a .lien in favor of the United States on all property and rights to <br />9904315394 -8 Pus' 1 <br />property belonging to this taxpayer for the amount of these taxes, and <br />FiLed: 01 130//2094 09:16 an <br />additional penalties, interest, and costs that may accrue. <br />r+ I, Ls <br />V 0 O V <br />Name of Taxpayer RAYMOND L & JULIE A MEYER <br />Residence 4245 SHANNA ST <br />GRAND ISLAND, NE 68803 -2903 <br />IMPORTANT RELEASE INFORMATION: For each asse:(e),this t listed below, <br />unless notice of the lien is refiled by the date given in column notice shall, <br />on the day following such date, operate as a certificate of se as defined <br />in IRC 6325(a), <br />Tax Period <br />Date of <br />Last Da for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiiing <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2000 <br />506 -76 -1025 <br />12/10/2001 <br />01/09/2012 <br />39308.51 <br />1040 <br />12/31/2002 <br />506 -76 -1025 <br />06/02/2003 <br />07/02/2013 <br />6895.72 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 46204.23 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 27th day of January <br />2004 <br />ST PAUL, MN <br />, on this, <br />Signature ,gyp Title <br />fe!� �' ; ACS 29 -00 -0008 <br />for S KIf�P (800) 829 -3903 <br />(NOTE- Certificate of officer authorized by lave to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 10 -00) <br />Part 1 - Kent By RecordinctOffice r^n'r non annoFv <br />