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v <br />03/30/2004 10:30 FAX 14024714429 NEBRASKA UCC <br />1008 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 M(c) Notice of Federal Tax Lien <br />(Rev. February 2004) <br />10004/004 <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />WAGE & INVESTMENT AREA #5 <br />Lien Unit Phone: (800) 829 -7650 <br />163905104 <br />Ni See of 646+. - ucc FTC <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 />9904325747 -9 Pus: t <br />property belonging to this taxpayer for the amount of these taxes, and <br />JE <br />F�edd: 03129/2004 03:34 PM <br />additional penalties, interest, and costs that may accrue. <br />20444304& <br />Name of Taxpayer JOSE & GUADALUPE PRADO <br />Residence 703 W 7TH ST <br />GRAND ISLAND, NE 68801 -4221 <br />NT RELEASE INFORMATION: For each assessment listed <br />]below, of the lien is refiled by the date given in column (e), this noticfollowing <br />Ethe;day <br />such date, operate as a certificate of release as d <br />1a1• <br />Tax Period <br />Date of <br />Last Dayy 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 />1040 <br />12/31/1991 <br />619 -03 -2790 <br />08/28/1995 <br />09/27/2005 <br />1097.50 <br />1040 <br />12/31/1992 <br />619 -03 -2790 <br />04/15/1993 <br />N/A <br />1040 <br />12/31/1992 <br />619 -03 -2790 <br />06/24/1996 <br />07/24/2006 <br />1.961.62 <br />Place of Filing <br />Register of Deeds <br />Hall P030X 1692 Total <br />$ 3059.12 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the i 23rd day of March <br />2004 <br />ST PAUL, MN <br />on this, <br />Signature ACS <br />AN DA 15 -00 -0000 <br />for W <br />(800) 829 -7650 <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) Form 668(y)(c) (Rev. 2 -2004) <br />