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;I- <br />i <br />12/07/2004 10:53 FAX 14024714429 <br />NEBRASKA_UCC CJ005 <br />260411767 <br />1872 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 (Y)(c) Notice of Federal Tax Lien <br />i <br />T <br />Serial Number <br />For Option Use by Recording Office <br />Area: <br />WAGE & INVESTMENT AREA #5 <br />Lien Unit Phone. (800) 629 -7650 <br />202183704 <br />I <br />Mr. S" es s�1a. - ucc Fn <br />I <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 />94363 Poo: 1 <br />property belonging to this taxpayer for the amount of these taxes, and <br />MMO IKE 71354E <br />Filed: 12/0312004 04:33 PM <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer JAMES L MOHNIKE <br />I <br />Residence <br />PO BOX 861 <br />GRAND ISLAND, NE 68802 -0861 <br />i <br />IMPORTANT <br />RELEASE INFORMATION: For each assessment listed below, <br />unless noliefo)f <br />the lien is refiled by the date given in column (e), this notice shall, <br />on the dllowing <br />such date, operate as a certificate of release as defined <br />in IRC 65(a). <br />Tax, Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />IGnd of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Reeling <br />of Assessment <br />a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />104b <br />12/31/1997 <br />507 -64 -8320 <br />06/07/2004 <br />07/07/2014 <br />4832.10 <br />1,040 <br />1/31/1998 <br />507- 64-8320 <br />06/14/2004 <br />07/14/2014 <br />4839.07 <br />1040 <br />12/31/1999 <br />507 -64 -8320 <br />06/14/2004 <br />07/14/2014 <br />4675.83 <br />1040 <br />12/31'/20100 <br />507 -64 -8320 <br />06/14/2004 <br />07/1;4/2014 <br />4370.18 <br />1040 <br />12/31'/2001 <br />507 -64 -8320 <br />05/31/2004 <br />06/3,0/2014 <br />3801.10 <br />1040 <br />12/31'/2002 <br />507 -64 -8320 <br />05/31/2004 <br />06/3,0/2014 <br />3566.70 <br />Place:of Filing <br />1�egist <br />r of Deeds <br />Hall .P <br />BOX 1692 Total <br />$ 26084.98 <br />Grand <br />Island,. NE 68802 -1692 <br />i <br />This notice was <br />p ,repa�ed <br />and <br />igned at ST PAUL, MN on this,, <br />i f <br />24th <br />the' <br />: <br />I :day <br />No <br />of �_ <br />ember 2004�� <br />sip 'nature <br />Title <br />ACS 15 -00 -0000 <br />for A <br />� <br />. j 2 I <br />(800) 829 -7650 <br />(NOTE: C�rt'rfi� <br />ate of officer a <br />horized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax Tien <br />i Rev. Rul. <br />71 -4 6, 19,71 - 2 C.B <br />409) Form 668(Y)(c) (Rev. 2 -20041 <br />. I <br />:.Parr t - Kent By Recordina Office I CAT. NO 60025X <br />i <br />T <br />