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07/2003 11:56 FAX 14024TI4429 NEBRASKA CCC [a BOB <br />109 _. tm se i..r. I 1'.I.,. --I,lz I. <br />Deparent Lie Treasury -Internal Revenue Se! I 'IIIIgI�Ip�II1R�ll�l� f I` <br />Form 668 (y)(<) <br />.vII IIMBIBII VIII` Illlllllllpl �II�II <br />,P. ORC..,2Wd, Notice of Federal Tax Lien <br />Area: Serial Number For Op <br />SMALL BUSINESS /SELF EMPLOYEI) AREA $9 1838 Pay.f <br />Uen Unit Phone: (Eo0) 829 - 3903 -. 390365081 rtF L JARESrYam 00, IS <br />m <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue -- <br />Code, we are giving a notice that coxes (including Interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a demand for payment of this liability, but k remains unpaid. Therefore, <br />there Is a Han in favor of the United States on all property and rights to <br />property belonghtg to this taxpayer for the amount of thaw =in, and 200300190 <br />additional penalties, Interest, and costs that may accrue. <br />Residence 903 W DIVISION <br />GRAND ISLAND, NE 68801 -6451 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the data given in column la), this notice shall, <br />on the day following such data, operate as a cenificate of release as defined <br />I. IBC 63251.1. <br />Kind of Tax <br />(a ) <br />Tax Perlod <br />Ending <br />(b) <br />Identifying Number <br />(c <br />Date of <br />Assessment <br />d <br />Lot Day for <br />KCMg <br />e <br />Unpaid Balance <br />of Assessment <br />f <br />1040 <br />12/31/1998 <br />508 -64 -6144 <br />11/19/2001 <br />12/19/2011 <br />12249.77 <br />1040 <br />12/31/1999 <br />508 -64 -6144 <br />02/25/2002 <br />03/26/2012 <br />10861.77 <br />1040 <br />12/31/2000 <br />508 -64 -6144 <br />11/19/2001 <br />12/19/2011 <br />7504.10 <br />Place of Fling <br />Register of Deeds <br />Hall POBO% 1692 Total <br />$ <br />30615.64 <br />Grand Island, NE 68802 -1692 <br />This notice was Prepared and signed at — —_ <br />the 02nd day of January 2003 <br />MILNAUKEE, NI <br />m this, <br />Signature }� f Title <br />,%'.fiZL -7� acs 27 -00 -0006 <br />for J GALLAGHER 1 (800) 829 -3903 <br />(NOTE: C,tfioete of afficer authorized by law to take ackeow,edgment Is not eseenrlal m the vain it, of Notice of Federal Tee flea <br />Bev. Bol. 71 -465, 19]1 -2 C.6.4091 <br />Rrt 1 • Kept BY yx w M" Form 669(T)(c) Rev. 1000, <br />CAT, NO 60025X <br />