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03/21/2005 10:49 FAg 14024714429 NEBRASKA UCC CJ005 /005 200502400 ,r, 1872 C Department of the Treasury - Internal Revenue Service Form 668 (Y)(c) Notice of Federal Tax Lien (Rev. February 2004) Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS /SELF EMPLOYED AREA #9 Lien Unit Phone: (651) 312 -8080 216832205 NE See M 5k04. -UCC FTL As provided by section 6321, 6322, and 6323 of the Internal Revenue Cede, we are giving a notice that taxes (including interest and penalties) have been assessed against the following -named taxpayer. We have made ' a demand for payment of this liability, but it remains unpaid. Therefore, there is a lien in favor of the United States on all property and rights to 990 5 P90 f property belonging to this taxpayer for the amount of these taxes, and VOJTA LEONA additional penalties, interest, and costs that may accrue. Filed: 03!16/2005 03:54 PM Name of Taxpayer LEONA VOJTA, SINGLE MEMBER Residence 15160 W BARROWS ROAD KENESAW, NE 68956 -9603 IMPORTANT RELEASE INFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column (e), this notice shall, on the day following such date, operate as a certificate of release as defined in IRC 6325(a). Tax Period Date of Last Day for Unpaid Balance Kind of Tax Ending Identifying Number Assessment Refiling of Assessment (a) (b) (c) (d) (e) M 940 12/31/2003 47- 0816667 11/22/2004 12/22/2014 370.95 Place of Filing Register of Deeds Hall POBOX 1692 Total $ 370.95 Grand Island, NE 68802 -1692 This notice was prepared and signed at ST PAUL, MN , on this, the 03rd day of March 2005 Signature TREVENUE OFFICER 29 -10 -2339 for KAY PONTE (308) 384 -6667 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev. Rul. 71 -466, 1971 - 2 C. B. 409) Form 668(Y)(c) (Rev. 2 -20041 Z