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02/25/2004 12:16 FAX 14024714429 NEBRASKA UCC <br />1008 <br />Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service <br />(Rev. February 2004) Notice of Federal Tax Lien <br />Area: Serial Number <br />SMALL BUSINESS /SELF EMPLOYED AREA #9. <br />Lien Unit Phone: (651) 312 -8080 158582204 <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 penakies) <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 LEONA VOJTA, SINGLE MEMBER <br />Residence 15160 W BARROWS ROAD <br />KENESAW, NE 68956 -9603 <br />For Optional Use <br />Q004/005 <br />Office <br />voara <br />Fi led: <br />WO: 40 RR <br />200401662 <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 />Kind of Tax Ending <br />Identifying Number <br />Date of <br />Assessment <br />Last Dayy for <br />Refi&g <br />Unpaid Balance <br />of Assessment <br />(a) (b) <br />(c) <br />(d) <br />(e) <br />(f) <br />2290 07/01/2001 <br />47- 0816667 <br />02/25/2002 <br />03/26/2012 <br />155.10 <br />2290 07/01/2002 <br />47- 0816667 <br />03/17/2003 <br />04/16/2013 <br />154.41 <br />941 12/31/2000 <br />47- 0816667 <br />05/07/2001 <br />06/06/2011 <br />110.53 <br />941 03/31/2001 <br />47- 0816667 <br />04/08/2002 <br />05/08/2012 <br />183.14 <br />941 03/31/2002 <br />47- 0816667 <br />11/18/2002 <br />12/18/2012 <br />3041.36 <br />941 06/30/2002 <br />47- 0816667 <br />Il/11/2002 <br />12/11/2012 <br />1371.16 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at.: ST PAUL, MN <br />the 20th day of February: 2004 <br />5015.72 <br />I <br />on this, <br />oignarure Title <br />REVENUE OFFICER. 29 -10 -233 <br />for KAik (308)" 384 -6667 <br />(]NOTE: Certificate of officer authorized. byelaw to take acknowledgment is not essential to the validity of Notice of. Federal Tax lien, <br />Rev..Rul. 71 -466, 1971 - 2 C.H. 409) Form.6d8(Y)(c) (Rev. 2-2004 <br />i,. <br />