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06/08/2004 16:09 FAX 14024714429 NEBRASKA UCC 200405673 Q005 Form 668 (Y)(c) Department of the Treasury - Internal Revenue Service (Rev. February 2004) Notice of Federal Tax Lien Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS /SELF EMPLOYED AREA #9 Lien Unit Phone: (651) 312 8080 175602604 FM See M Sksk.0 -UCC FTL 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 991114337333 -4 property belonging to this taxpayer for the amount of these taxes, and PEASE NQ1} L additional penalties, interest, and costs that may accrue. Filed: 06/08/2004 11:31 an Name of Taxpayer NATHAN I PEASE Residence 2104 W DIVISION APT 3 GRAND ISLAND, NE 68803 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 Kind of Tax Ending Identifying Number I Assessment Refilling 1040 112/31/20001 507 -15 -6721 104/15/20011 05/15/2011 1040 12/31/2000 507 -15 -6721 05/12/2003 06/11/2013 Place of Filing Register of Deeds Hall POBOX 1692 Grand Island, NE 68802 --1692 This notice was prepared and - signed at ST PAUL, YIN Unpaid Balance of Assessment 11062.76 Total 1$ 11062.76 , on this, the 02nd day of June 2004 J Signature 'M*-,,PAh1fff %MPArky e ' 0 E' ACS 15 -00 -000( for WANDA W. BROWN (8 00) 829 -7650 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -20041 Part t - Kept By Recording Office CAT. NO 60025X