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12/22/2004 18:11 FAX 14024714429 NEBRASKA UCC 200412298 (}{ 9303 Department of the Treasury - Internal Revenue Service Form 668 (Y)(9 Notice of Federal Tax Lien IRev. February 2004) Area: Serial Number For Option. SMALL BUSINESS /SELF EMPLOYED AREA ##9 Lien Unit Phone: (651) 312 -8080 205472004' 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 ail 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 HERBERT L MOSTEK Z008/008 I use by Recording Office FTL I i 367696 -0 Pgsr f � : �R22R2004 03:40 PM Residence 3111 W COLLEGE APT 73 GRAND ISLAND, NE 68803 -1755 E TANT RELEASE INFORMATION: For. each assessment listed below, tice of the lien is refiled by the date given in column (e), this notice shall, ay following such date, operate as_ a certificate of release as defined 325(a). Tax Period Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number. Assessment Refilling of Assessment (a) (b) (c) (d) a (fl 1040 12/31/2000 508 -86 -9302 03/10/2.003 04/09/2013 13735.60 Place of Filing Register of Deeds Hall POBOX 1692 Total $ Grand Island, NE 68802 -1692 13735.60 This notice was prepared and signed at ST PAUL, MN _ on this, the 15th da of December 2004 Y Signature ACS 29 -00 -0008 for S KILPATRICK (800) 829 -3903 (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 1 - Keot By Recording Office CAT. NO 60025X