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1 <br />06/09/2005 08:56 FAX 14024714429 NEBRASKA UCC <br />Q003/003 <br />1872 <br />pepartment of the Treasury _ Internal Revenue Service <br />Notice Of Federal Tax Lien <br />Fong 666 (y)(0 Notice Office <br />(Rev. February 2004) Far Optional Use by <br />Serial Number FtL <br />Area: EA #9 we �.� eI L�r4r - UCG <br />Shea: BUSINESS /S7 ;/SELF EMPLOYED <br />z3D796605 <br />Lien Unit Phone: (800) 913 -6050 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />a notice that taxes (including interest and penalties) , <br />Code, tore are giving hits the at taxing`named taxpayer. We have made <br />have been assessed ago but it remains unpaid. 'therefore, ggg539$274 -6 <br />a demand far payment of this liability, property and rights to FOKKEN DARREL K <br />there is a lien in favor of the United l the amour of these taxes, and <br />F,l.d; me1meizmms ma:at PM <br />property belonging to this taxp Y accrue- <br />- additional penalties, interest, and costs that may <br />Name of Taxpayer DARREL K FOKKEN 3RD S <br />Residence G°WTSLANDT NE 68801 -5832 <br />RAND IMPORTANT RPI.WE n4FORMATIOM. For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column la), this notice shall, <br />on the day following such date, operate as a certificate of release as defined . i - .— <br />in IR pate of C 6325(a). last Day for Unpaid Balance <br />- Refiling of Assessment <br />Tax period Identifying Number Assessment <br />fund of Tax Ending - d e 12283.78 <br />a) (b) (c <br />14252.88. <br />1040 12/31/1999 484-46 -8652 09/29/2003 10/29/2013 10800.96 <br />1040 12/31/2000 484 8773.15 <br />1040 12/31/2001 464-46-6652 78652 11/15/2004 12/15/2014 .500.00 <br />1040 12/31/2002 48 <br />6682 12/31/2001 464 -46 -8652 03/29/2004 04/28 <br />Place of Filing Register of Deeds Total $ 46610.77 <br />Hall POBOX 1692 68802 -1692 <br />Grand Island, NE <br />, on this, <br />ST PAUL, MN <br />This notice was prepared and signed at <br />June 2005 <br />01st day <br />the of �� <br />�� <br />Title 29 -10 -2339 <br />REVE E NU OFFxCER <br />Signature (308) 384 -6667 <br />for KAY PONTE 668(n(C) (Rev^ 2 -2004) <br />taw to take acknowledgment is not essential to the validity aFo onlce of Federal Tax lien <br />