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12/20/2002 10:01 FAX 14024714429 NEBRASKA ❑CC 1@0e6 IIII�''IIg1111 _ <br />- et aa'I NII <br />pa IIIIIN�iIIHl�l�ll�� <br />Department of the Treasury - Internal Revenue <br />Form 668 (y)(c) Notice of Federal Tau Lien 11IN�I�IIII <br />lPeo_notoGef 2WOr <br />Area, Serial Number A' Pe" t <br />gge2R1928e -2 <br />SMALL SJSIt SS /SELF EMPT.OYED ARBA #9 ntrtfiNeRINK t1�00R5 P <br />Lian Unit Phone: (414) 297 -3211 390264393 MF 17- 12112: 002 12 20 °M _ <br />As provided by section 6321, 6322, and 6323 of the Internal neeeone <br />Code, we are giving a notice that taxes (including Interest and penalties) <br />love been assessed agalnsr the foilowiog -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 aU property and rights to <br />property belonging to this taxpayer her the amount of these rues, and <br />additional penalties, interest, and costs . that may accrue, <br />200214328 <br />Residence 1324 WN FRONT ST <br />GRAND ISLAND, NE 68801, <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below. <br />unless notice of the No is taeled by the date given In column (a), this notice shell, <br />on the day following such dam, operate as a certificate of release as defined <br />in IRC 6326(al. <br />Tax Perhod Date of Last Day for Unpaid Balance <br />Kind of Tax EoNng Identifying Number Assessment Ref -[ling of Assessment <br />a b) (c d e f <br />1040 12/31/2000 S06 -64 -3732 09/10/2001 iD/10/2011 1 6687,32 <br />Place of Filing <br />Register of reeds Total $ <br />Hall POBOX 1692 fi687.32 <br />Grand Island, NE 66802 -1692 <br />This notice was prepared and signed at -. MILWAUKEE, WI , on this, <br />the 13th day of December 2002 <br />Signature Title <br />rt.CZ REVENUE OFFICER 29 -1C -2337 <br />`cr MICHAEL W PCN"E 1 (308) 384 -6668 <br />(NOTE: certificate of eminer authorized by law to take acknoWedoment Is not essential to Ne veudoy of Nonce of Federal Taa Imn <br />Rev. eul. 71 466. 1971 - 2 0.9. 409) Porm 6ee(Y)(0 IRev. 10.00) <br />Pan 1 - see, By Re eoll.1 Offloe CAT. NO 60025% <br />