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04/15/2005 08:50 FAX 14024714429 NEBRASKA UCC 10002 /002 <br />24p, <br />20U503327 <br />Farm bb$ (Y)(c) Department of the Treasury - Internal Revenue Service <br />(Rev. February 2004) Notice of Federal Tax Lien <br />___t_ <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 Serial Number <br />Lien Unit Phone: (651) 312 -8080 222518305 <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 />addnt -ronal penalties, interest, and costs that may accrue. <br />Name or I axpayor 'THOMAS A WAGONER <br />Residence 1819 W NORTH FRONT ST <br />GRAND ISLAND, NE•68803 -4706 <br />For Optional Use by Recording Office <br />slata - UCC FTL <br />i <br />i <br />990$389712 -•4 Pas: 1 <br />FAI ed R n; 412005 03:22 PM <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />an the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period Date of Last Da yy for <br />Kind of Tax Ending Identifying Number Assessment Refiling <br />(a) (b (c) (d) (e) <br />941 09/30/1999 47- 0550792 10/11/2004 11/10/2014 <br />Place of Filing <br />Regist -er of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 08th day of April <br />Signature <br />for KATHY MA.LLETT <br />2005 <br />ST PAUL, MN <br />Total 1$ <br />Unpaid Balance <br />of Assessment <br />(f) <br />704.29 <br />704 -29 <br />, on this, <br />Title <br />REVENUE OFFICER 29 -10 -2326 <br />(4 02) 221 -3403 <br />(N!UTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />ReV. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Farm 668(Y)(c) (Rev. 2 -20041 <br />Part t - Kebt By Recordin¢ Office ... _ .1- ----- 11 D"T- <br />