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11.,,13!2002 17:26 FAX 14024714429 NEBRASKA UCC <br />200211)560 <br />Form 668 (Y}(c) 59625 <br />Department of the Treasury • Internal Revenue Service <br />i9ey. October 2000) Notice of Federal Tax Lien <br />Area: Serial Number P <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Pnone: (4_4) 297 -3211 390262973 <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 belin 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 Taxpaver JACK W & THERESA L LILLIBRTDGF. <br />Q007/008 <br />aa Pm <br />Residence 3 C 9 CARDINAL DR <br />GRAND ISLAND, NE 68803 <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 AC 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 />Refiling <br />of Assessment <br />a <br />b <br />c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2000 <br />507 -56 -0223 <br />10/01/2001 <br />10/31/2011 <br />9694.88 <br />Place of Filing <br />Register of Deeds Total <br />$ <br />Hall POPDX 1692 <br />9694.83 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and s,'gned at MILWATJKFE, WI <br />on this, <br />the 06th day of November 2002 <br />Signature �/ <br />Title <br />ACS <br />14-00-0000 <br />Lcr R PICKARD <br />(800) 829 -7650 <br />(NOTE: Certificate of officer autnorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -466, 1 971 - 2 C.B. 409) <br />Firm bb9(i(e) (Rev. 10 -00i <br />Part 1 - Kept By Recording Office <br />CAT. NO 60025X <br />