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02/25/2004 12:17 FAX 14024714429 <br />[ <br />9 <br />loos <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />NEBRASKA UCC <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number For optional u <br />SMALL BUSINESS /SELF EMPLOYED AREA 49 <br />Lien Unit Phone: (651) 312 -8060 158582304 <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 liabliky, 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 />'ame of Taxpayer LEONA L VOJTA . <br />Residence 15160 W BARRowS RD <br />KENESAW, NE 68956 -9603 <br />10005/005 <br />y Recording Office <br />VOJTR LEONp L 'a.; r <br />Filed: 02125/2004 09;40 AM <br />200401661 <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 shalt, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period Date of Last Da for <br />Kind of Tax Ending Identifying Number Assessment Refiring <br />(a) (b) '(c) (d) e) <br />1040 12/31/2000 505 -84 -0858 10/08/2001 11/07/2011 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ <br />Grand Island,: NE.68802 -1692 <br />Unpaid Balance <br />of Assessment <br />7642.08 <br />7642.08 <br />This notice was prepared and signed at ST PAUL, MN <br />on this, <br />the 20th day of February 2004 , <br />Signature 3 . Title <br />REVENUE OFFICER 29 -10 -2339 <br />for KAY PONTE (308) 384- 66.67 <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 />i Part 1 - Kept By Recording Office .. Form 668(Y)(c)`4Ray. 2 -2004) <br />. rnT nrn ennw <br />