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02/06/2004 17:58 FAX 14024714429 <br />i% <br />NEBRASKA UCC <br />Q002/002 <br />This notice was prepared and signed at <br />the 02nd day of February <br />2004 <br />ST PAUL, MN <br />, on this, <br />Signature �. Title <br />'��iZ.ea REVENUE OFFICER 29 -10 -2339 <br />for KAY PONTE (308) 384 -6667 <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. 409) <br />Part i - Kept B Recording Office Form 668( CAT (Rev. 1025X <br />Y CAT. N0,60025X <br />4 <br />1008 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 (Y)(c) <br />Notice of Federal Tax Lien <br />(Rev. October 2000) <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 />155315604 <br />No Be. D.:ta•e - ucc FTL <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 />9904317086 -7 Ppo: 1 <br />property belonging to this taxpayer for the amount of these taxes, and <br />LEONA VOJTA, SINGLE MEMBER, A <br />Filoi 02!08/2004 02:49 PM <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer LEONA VOJTA, SINGLE MEMBER , a Corporation <br />Residence 15160 W BARROWS ROAD <br />KENESAW, NE 68956 -9603 <br />200401148 <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 6325(a). <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />940 <br />12/31/2002 <br />47- 0816667 <br />10/24/2003 <br />11/23/2013 <br />1447.19' <br />941 <br />12/31/2002 <br />47- 0816667 <br />10/16/2003 <br />11/15/2013 <br />1348.58 <br />941 <br />06/30/2003 <br />47- 0816667 <br />10/16/2003 <br />11/15/2013 <br />1009.07 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 3804.84 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 02nd day of February <br />2004 <br />ST PAUL, MN <br />, on this, <br />Signature �. Title <br />'��iZ.ea REVENUE OFFICER 29 -10 -2339 <br />for KAY PONTE (308) 384 -6667 <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. 409) <br />Part i - Kept B Recording Office Form 668( CAT (Rev. 1025X <br />Y CAT. N0,60025X <br />4 <br />