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09/21/2005 08:50 FAX 14024714429 <br />1872 <br />Forth 668 (Y)(c) <br />(Rev. February 2004) <br />NEBRASKA UCC IM 002 <br />200509333 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (800) 913 -6050 247900105 <br />As provided by section 632t, 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 taxpayelr for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />ame of Taxpayer <br />& BEVERLY A <br />Residence 2216 GATEWAY AVE <br />GRAND ISLAND, NE 68803 --2243 <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 IRC 6325 -(a). <br />For Optional Use by Recording Office <br />N8 Sae of Sisis John R Gels - 4[[ PtL <br />fill Hall 1111111 1111111111111 gill 111111111111 IM <br />i <br />9905413444 -6 p9s : f <br />REDWINE WILLIAM E ! <br />Filed: 091201200E 08:88 IM <br />Tax Period Date of Last Day for <br />Kind of Tax Ending Identifying Number Assessment Refiling <br />(a) (b) c d) (e) <br />1040 12/31/2001 448 -16 -5184 04/18/2005 05/18/2015 <br />Place 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 13th day of September 2005 <br />ST PAUL, MN <br />Signature Title <br />�dClaJ�,� REVENUE OFFICER <br />for MICHAEL W PONTE (308) 384 -4850 <br />Unpaid Balance <br />of Assessment <br />14767.03 <br />Total $ 14767.03 <br />on this, <br />r �yy'6 <br />29 -10 -2337 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal I ax lien <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(1r)(c) (Rev. 2 -2004) <br />D..# 1 - Van+ RV Rarardino Off'i[E r Ar nin Qnn7rV <br />