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06/16/2004 16:30 FAX 14024714429 F`�! v NEBRASKA UCC 200406013 IM 002/002 This notice was prepared and signed at the 08th day of June Signature , for S KILPATRICK 2004 ST PAUL, MN Title ACS (B00) 829 -3903 , on this, � v 29 -00 -0008 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Fedoral Tax lien Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev- 2 -2004) 1008 Department of the Treasury - Internal Revenue Service 668 (Y Notice of Federal Tax Lien {Rev. February 20041 04) (Rev. Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS /SELF EMPLOYED AREA #9 Lien Unit Phone: (800) 829 -3903 176217204 W sae of state - UGC FM 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 � JEREMY P9�: WATSON WgTSON JEREMY R additional penalties, interest, and costs that may accrue. Filed: 06/16/2004 03:29 PM Name of Taxpayer JEREMY R WATSON Fx ELIZABETH WATSON Residence 2605 COTTONWOOD RD GRAND ISLAND, NE 68801 -7545 TANT RELEASE INFORMATION: For each assessment listed below, tice of the lien is refiled by the date given in column (e), this notice shalt, EIRhC ay following such date, operate as a certificate of release as defined 325(al. se Tax Period Date of La st Dayy for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refil'mg of Assessment (a) (b) (c) (d) (e) (f) --.040 12/31/2001 507 -19 -4139 06/24/2002 07/24/2012 5017.05 Place of Filing Register of Deeds Hall POBOX 1692 Total $ 5017.05 Grand Island, NE 68802 -1692 This notice was prepared and signed at the 08th day of June Signature , for S KILPATRICK 2004 ST PAUL, MN Title ACS (B00) 829 -3903 , on this, � v 29 -00 -0008 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Fedoral Tax lien Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev- 2 -2004)