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04;29/2003 16:45 FAX 14024714429 NEBRASKA UCC <br />668 (Y)(c) <br />F 109 <br />(� Department of the Treasury - Internal Revenue <br />orm <br />(Rev. October 20001 Notice of Federal Tax Lien <br />Area: Serial Number For <br />WAGE & INVESTMENT AREA #5 <br />Lien Unit Phone: (goo) 929 -7650 390369369 <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 />there is a lien in favor of the United 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 />Name of Taxpayer DEE ANNA M FRITZ <br />Residence PO ,BOX 1156 <br />GRAND ISLAND, NE 68802 -1156 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given In column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period Date of Last Da yy for <br />IGnd of Tax Ending Identifying Number Assessment Reflling <br />(a) b (Cy- (d) I (e) <br />1040 112/31/20001 484 -72 -9289 107/23/20061T 08/22/2011 <br />1040 12/31/2C01 484 -72 -9289 06/24/2002 07/24/2012 <br />Place of Filing <br />Q002; 002 <br />Register of Deeds Total $ <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI <br />the 22nd day of April 2003 <br />PAWA M <br />28/2003 03A6 PM <br />200305324 <br />Unpaid Balance <br />of Assessment <br />2991.64 <br />1774.74 <br />4766.39 <br />, on this, <br />Signatulkilil r I �� Title - <br />(/ Al 14 -00 -0000 <br />for R PICKARD (800) 829 -7650 <br />(NUTS: Certificate of officer author.2ed by law to take acknowledgment is not esserttial to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 <br />Part 1 - Kept By Recording Office Form 668(Y)(c) (Rev. 1 o -co) <br />CAT. NO 60025X <br />a <br />ti <br />i <br />I <br />