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02124/20U3 17:18 FAX 14024714429 NEBRASKA UCC <br />12002/002 <br />200302324 <br />Form 668 (Y)(c) 109 <br />Department of the Treasury - Internal Revenue Service <br />�Ro. oneoer2e00l Notice of Federal Tax Lien <br />�• — <br />Lien Serial Number IIIIIIIIIIII 'ry IIII�II(ll i" <br />"'rnALL Bus 2taESS /SE -F EMPLOYED AREA #9 IIEII I- rylpppl�lplpp IIIggI ��Illl� <br />Lien Unit Phone; (914) 299 -3211 390366696 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that rues (including interest and penalties) <br />have been assessed against the fol owing -named taxpayer. We have made �oazs a - na•: <br />a demand for payment of this 11 Fit. OEeol�6e t <br />abghy, but It remalus unpaid. Therefore, Tame: 03rs ,saes 03 27 an <br />there is a Her in favor of the Untied States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Residence 704 W 3RD ST <br />GRAND ISLAND, KE 68801 -5826 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refilad by the data given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in RC 63251a). <br />Tax Period <br />Date of <br />Last DaaYy for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />RefBing <br />of Au essment <br />a <br />b <br />(c) <br />d <br />e <br />f <br />941 <br />12/31/2000 <br />47- 0768965 <br />12/16/2002 <br />01/15/2013 <br />2228.74 <br />,41 <br />03/31/2001 <br />47- 07(58965 <br />12/16/2D02 <br />)1/15/2013 <br />2077.99 <br />541 <br />06/30/2001 <br />47- 0768965 <br />12/16/2002 <br />01/15/2D13 <br />2514.32 <br />941 <br />09/30/2001 <br />47- 0768965 <br />12/23/2002 <br />01/22 /2013 <br />2187.80 <br />941 <br />06/30/2002 <br />47- 0768965 <br />12/30/2002 <br />01/29/2013 <br />2959.76 <br />Place of Filing <br />Register of Deeds Total <br />$ <br />?call POBOX 1692 <br />11968.61 <br />Grand Island, NE 68SC2 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI , on this, <br />the 14th day of February 2003 �. <br />9(�. <br />Signature s..,,,, Title <br />/7) REVENGE OFFICER 29 -10 -2341 <br />for PAT LLOGG (308) 384 -6662 <br />(NOTE: Certitlrate of officer authorized by law m take acknowledemam Is not essemial to the v&Jidlty of Notice of R,daml Ta. an <br />Rev. Rut. 71- x66.1971 -2 C B. 409) Form 66aOD(e)IP.,. 10-001 <br />Pan 1 - Kan: Br as su lair Offiu r-er un annoFv <br />I <br />1 <br />