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04!08/2003 16:51 FAX 140241.14429 NEBRASKA UCC <br />Form 668 (Y)(c) <br />(Ray. Octobar 2000) <br />109 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Ca002/003 <br />Area: <br />Serial Number <br />For Optional Use by Recording Offica <br />WAGE S INVESTMENT AREA #5 <br />saa of ��••' - uee <br />Lien Unit Phone: (800) 8.29 -7650 <br />390368648 <br />w <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 />Pte: <br />there is a lien in favor of the United States on all property and rights to <br />+���" 9 <br />9s03 sa:mi a>h <br />1 <br />12%6 <br />property belonging to this taxpayer for the amount of these taxes, and <br />HILedM ff <br />Filad <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer DARRELL S HILTZMAN <br />Residence PO BOX 1102 <br />GRAND ISLAND, NE 68802 -1102 <br />ORTANT RELEASE INFORMATION: For each assessment listed below, <br />s notice of the lien is refilled by the date given in column (e), this notice shall, <br />E <br />e day following such date, operate as a certificate of release as defined <br />C 6325(a}. <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refilling <br />of Assessment <br />a <br />b <br />c) <br />(d ) <br />1040 <br />12/31/1996 <br />323 -40 -3499 <br />11/24/1997 <br />12/24/2007 <br />11034.25 <br />Place of Filing <br />Register of Deeds <br />Total <br />$ <br />Hall POSOX 1692 <br />11034.25 <br />Grand Island, NE 66802 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI <br />, on this, <br />the 03rd day of APr 1 2003 C:- <br />Si '(erg% . l'' Title <br />+ t ` ACS 14 -00 -0000 <br />=or R PICKARD (800) 629 -7650 <br />(.407pi. Csrvf,cats of officer authorized ny law to take acknowledgment is not essential to the validity of Not'oe of Federal Tax her. <br />Ray. Rul. 7; -466, ?971 - 2 C. E. 4091 Form 666, " )fc) (Rev. 10 -03) <br />A }� <br />R <br />