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�t L <br />0903!2003 16:16 FAX 14024714429 NEBRASKA UCC <br />200311860 <br />Q002/002 <br />This notice was prepared and signed at <br />the 28th day of August <br />2003 <br />ST PAUL, MN <br />, on this, <br />Signature Title <br />ACS _ 15- 00 -0000 <br />for B STRUD ` (800) 829 -7650 <br />(NOTE: Certificate of officer authorized by law to take eoknowledgrrent is not essential to the validity of Notice of Federa; Tax Hen <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 10 -00) <br />L <br />1008 <br />department of the Treasury - internal Revenua Service <br />Form 666 (Y)(c) <br />Notice of Federal Tax Lien <br />(Rev, Octaber 20001 <br />Area: <br />Serial Number <br />F' NE SOL or il. ■ �UCC <br />WAGE & INVESTMENT AREA #5 <br />Lien Unit Phone; (800► 829 -7650 <br />132012903 <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 nude <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />99E3293 Ob5 -2 <br />NELCON JEFF A A°° f <br />there is a lien In favor of the United States on all property and rights to <br />FItod: eSI02/2003 04:26 PM <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer JEFF A & TONDA J ' ERLSON <br />Residence 1521 W LOUISE ST <br />GR;ZND ISLAND, NE 68801 -6326 <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 />Tax Period <br />Date of <br />Last Dayy for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiiing <br />of Assessment <br />a <br />b <br />c <br />(d) <br />(e ) <br />f) <br />1040 <br />12/31/1996 <br />505 -82 -2371 <br />10/14/2002 <br />11/13/2012 <br />724.27 <br />104C <br />12/31/1997 <br />505 -82 -2371 <br />08/19/2002 <br />09/18/2012 <br />3815.19 <br />1040 <br />12/31/200D <br />505 -82 -2371 "05/28/2001 <br />06/27/2011 <br />807.22 <br />1040 <br />12/31/2002 <br />505 -82 -2371 <br />06/02/2003 <br />07/02/2013 <br />327.34 <br />Place of Filing <br />Register of Deeds <br />HaK POBOX 1692 Total <br />$ 5674.02 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 28th day of August <br />2003 <br />ST PAUL, MN <br />, on this, <br />Signature Title <br />ACS _ 15- 00 -0000 <br />for B STRUD ` (800) 829 -7650 <br />(NOTE: Certificate of officer authorized by law to take eoknowledgrrent is not essential to the validity of Notice of Federa; Tax Hen <br />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 10 -00) <br />L <br />