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05/20/2W5 16:25 FAX 14024714429 NEBRASKA UCC <br />IN <br />1872 <br />Form 668 M(c) <br />(Rev. February 20041 <br />Area: . <br />WAGE & INVESTMENT AREA 45 <br />200504002 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number - F0r <br />Lien Unit Phone: (800) 829 -7650 226881405 <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 llability, 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 />me of Taxpayer ALLEN H PRICE <br />Residence 1015 W 9TH <br />GPAND ISLAND, NE 68801 -4124 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date divan 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 />Piace of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 06th day of May 2005 <br />Signature <br />fnr WANDA W. BROWN <br />Q'P PAT 77 . W <br />ional Use by Recurdin <br />Q003/005 <br />o"ice <br />ME r-a sf 51rir - tICC FTL <br />I <br />i <br />9905395672 -5 Pgs: 1 <br />PRICE ial LEN H <br />Filed: 0512m <br />120N 08.21 PA <br />Last Day for <br />Tax Period <br />Refilling. <br />Date of <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />1040 <br />12/31/2000 <br />515 -68 -2291 <br />12/23/2002 <br />1040 <br />12/31/2001 <br />515 -68 -2291 <br />04/15/2002 <br />1040 <br />12/31/2001 <br />515 -68-2291 <br />03/29/2004 <br />1040 <br />12/31/2002 <br />515 -68 -2291 <br />04/15/2003 <br />1040 <br />12/31/2002 <br />515 -68 -2291 <br />10/04/2004 <br />Piace of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 06th day of May 2005 <br />Signature <br />fnr WANDA W. BROWN <br />Q'P PAT 77 . W <br />ional Use by Recurdin <br />Q003/005 <br />o"ice <br />ME r-a sf 51rir - tICC FTL <br />I <br />i <br />9905395672 -5 Pgs: 1 <br />PRICE ial LEN H <br />Filed: 0512m <br />120N 08.21 PA <br />Last Day for <br />Unpaid Balance <br />Refilling. <br />of Assessment <br />(e)' <br />M- <br />01/22/2013 <br />844.63 <br />05/15/2012 <br />04/28/2014 <br />6420.64 <br />05/15/2013 <br />11/03/2014 <br />6974.94 <br />Title <br />ACS <br />(800) 829 -7650 <br />Total 1$ 14240 -21 <br />, on this, <br />15 -00 -0000 <br />(NOTE. Certificate of officer authorized by law ro take acknowledgment is not essential to the validity of Notice of reoerai i ax inn l J <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 4091 Form 668(y)(c) (Rev. 2 -2004) <br />n.._. -9 - V—. R. Rer Minv Office r LT nln F0n95x C' <br />