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<br />01/26/2006 13:41 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />141 009/011 <br /> <br />b <br /> <br />1872 <br /> <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien , <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 267481706 <br /> <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 liability, but it remains unpaid. Therefore,' <br />there is a lien in favor of the United States on all property and tights to ; <br />property belonging to this taxpayer for the amount of these taxes, and I <br />additional' penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer WHITNEY C DRAKE <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />9908434474-6 pgs: 1 <br />DRAKE WHITNEY C <br />Fil.d: 01/2412006 04:32 PM <br /> <br />Residence <br /> <br />2323 BELLWOOD DR 110 <br />GRAND ISLANQ, NE 68801-6205 <br /> <br />20060073'0 <br /> <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 IRe 6325(a). <br /> <br />Kind of Tax <br />(a) <br />1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2004 <br /> <br />Identifying Number <br />(c <br />XXX-XX-7449 <br /> <br />Date of <br />Assessment <br />(d <br />06/27/2005 <br /> <br />Last~ Day for <br />~efiling <br />I (e) <br />07/27/2015 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />3907.25 <br /> <br />Place of Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />Total $ <br /> <br />3907.25 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />the <br /> <br />12 th day of January <br /> <br />2006 <br /> <br />Signature /J- / ./ Title <br />'AXlttAJ U.. n~ REVENUE OFF~CER <br />for KAY PONTE '(308) 384-4a50 <br />(NOTE: ce~ficate of officer But~orized by law to take acknowledgment is not essential ,to the validity of' Notice of Federal Tal( lien <br />Rev. Ru!. 71.466, 1971 - 2 C.B. fOg) D__ . _ v_.. II.. Dft~~r~;n_ nm~.. I Form 66B(Y~((:2 (_~~v:.~:~~~~) <br /> <br />24-10-2339 <br /> <br />\{C <br />