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05:'28/2002 15:02 FAX 14024714429 NEBRASKA UCC <br />♦� <br />[a003/004 <br />This notice was prepared and signed at <br />the 23rd day of August <br />2002 <br />MILWAUKEE, WI <br />on this, <br />Signature.'� r Title <br />ACS 14 -00 -0000 <br />for R PICKARD (800) 829 -7650 <br />(NOTE: Certificate of officer authorized by low to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 <br />Part I • Kept By Retarding Office form 668( CAT I . NO 10-001 <br />CAT. 60026x <br />109 <br />Department of the Treasury - Internal Revenue <br />Service <br />Form 668 (Y)(e) <br />Notice of Federal Tax Lien <br />ae <br />sae m %tat. - act . <br />i Re,. Ootaber 2000) <br />For o <br />Ares: <br />Ser ial Number <br />WAGE 4 INVESTMENT AREA #5 <br />Lien Unit Phone: (Boo) 829 -76 50 <br />390260562 <br />saezzaaau —I Pe: , <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 />FFiledNDa� r79/i00e2 12 23 Rn <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 an 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 />200209066 <br />Name otTaxoayer NICOLAS HERNANDEZ <br />Residence 324 WALNUT GTH <br />GRAND ISLAND, NE 68601 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (a), this notice shall, <br />an the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period <br />Date of <br />Last ppaayy for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Reining <br />of Assessment <br />a) <br />b <br />c) <br />d <br />e <br />1040 <br />12/31/1996 <br />595 -49 -0843 <br />05/31/1999 <br />06/3012009 <br />12308.14 <br />Place of Filing <br />Register of Deeds Total <br />$ <br />Hall POBOX 1692 <br />12308.14 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 23rd day of August <br />2002 <br />MILWAUKEE, WI <br />on this, <br />Signature.'� r Title <br />ACS 14 -00 -0000 <br />for R PICKARD (800) 829 -7650 <br />(NOTE: Certificate of officer authorized by low to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 <br />Part I • Kept By Retarding Office form 668( CAT I . NO 10-001 <br />CAT. 60026x <br />