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4. 05/05/2004 16:59 FAX 14024714429 NEBRASKA UCC CJ002 /003 200404515 �t 1008 Department of the Treasury - internal Revenue Service Form 668 (Y)(c) Notice of Federal Tax Lien (Rev. February 2004) Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS /SELF EMPLOYED AREA #9 170583904 Lien Unit Phone: (651) 312 -8080 As provided by section 6321, 6322, and 6323 of the Internal Revenue Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the following -named taxpayer. We have made a demand for payment of this liability, but it remains unpaid. Therefore, there is a lien in favor of the United States on all property and rights to property belonging to this taxpayer for the amount of these taxes, and additional penalties, interest, and costs that may accrue. Name of Taxpayer JERRY L & CAROLE L DENTON Residence 205 S CEDAR GRAND ISLAND, NE 68801 -6501 IMPORTANT RELEASE INFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column (e), this notice shall, on the day following such date, operate as a certificate of release as defined in IRC 6325(a). Tax Period Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refilling of Assessment (a) (b) (c) (d) (e) (f) 1040 12/31/2002 505 -52 -3010 12/15/2003 01/14/2014 136505.87 Place of Filing Register of Deeds Hall POBOX 1692 Total $ 136505.87 Grand Island, NE 68802 -1692 This notice was prepared and signed at the I 30th day of April 2004 ST PAUL, MN on this, Signature ,6° REVENUE OFFICER 29 -10 -2337 fnr MICHAEL E,� SCR' (308) 384 -6668 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal I ax lien Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -2004) ...T . 1-1— A