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92/19/2003 17:17 FAX 14024714429 NEBRASKA ➢CC [2 005 005 <br />200302024 <br />-.09 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 (tp(c) <br />„p„ 20pp, Notice of Federal TeX Lien <br />Area: Serial Number Rmr 0p 2nel Use by Reaordin OfBm <br />SMALL BUS -NESS /SELF El4PLOYED n A 49 rs •• rr•r• - ucr <br />Lien Unit Phone: (4L4) 297-3211 al Revenue Illialll ll I l�all IIIlillll I II II <br />As provided by section 6341, 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, son= a•: 1 <br />there is a Een in favor of the United States on all property and rights to PEi.a amiairtams am on <br />property belonging to thU taxpayer for the amount of these taxes, and I - <br />additional penalties, Internal and and costs that may ace. <br />Residence 515 N GREENWICH <br />GRAND ISLAND, NE 68801 -4451 <br />IMPORTANT RELEASE INFORMATION: Far each assessment listed below, <br />unless notice of the lien is refiled by the date given in column lei, this notice ahall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 63251a1, <br />Kind of Tax <br />a <br />Tax Period <br />Ending <br />b) <br />Identifying Number <br />c <br />bate of <br />Assessment <br />(d) <br />Last Daayy for <br />Reif 9 - <br />(a) <br />Unpaid goings <br />of said list <br />(f) <br />940 <br />12/31/1997 <br />91- 1813760 <br />96/04/2001 <br />07/04/2011 <br />658.31 <br />94D <br />12/31/1999 <br />91- 181376C <br />04/30/2001 <br />05/30/2011 <br />708.73 <br />941 <br />06/30/1997 <br />91- 1813760 <br />04/23/2001 <br />05/23/2011 <br />648.81 <br />941 <br />12/31/1997 <br />91- 1813760 <br />04/23/2001 <br />05/23/2011 <br />409.17 <br />941 <br />09/30/1998 <br />91- 1813760 <br />04/23/2001 <br />05/23/2011 <br />390.22 <br />941 <br />12/31/1998 <br />91- 1813760 <br />04/23/2001 <br />05/23/2011 <br />342.98 <br />941 <br />06/30/1999 <br />91- 1813760 <br />04/23/2001 <br />05/23/2011 <br />1351.08 <br />Place of Filing <br />Register of Deeds Total <br />9 <br />Hall POBOX 1692 <br />4509.30 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI <br />the _ 13th day of February 2003 <br />Signature f Title <br />y�L.�e+`VP 3.i�...e REVENUE OFFICER <br />_or PAT KELLOGG - (308! 384 -6662 <br />(NOTE: Certificzte of aRlcer aichmr'aed by hew tc take acknowledgmem la net essentlel to the v <br />Rsv. RA 71- 488.1971 2 C.B. 409; <br />Part 1 - Kept er aecordlnr Oma <br />t <br />on this, <br />29 -10 -2341 �� <br />Form 66a(yj(c) [Rev. 10-001 <br />CAT. NO 60[25X <br />