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<br />06/05/2006 16:06 FAX 14024714429 <br />I <br /> <br />NEBRASKA Dee <br /> <br />~ 0021004 <br /> <br />200605043 <br /> <br />~. .. <br /> <br />Form 668 (Y)(c) <br />(R9V, February 2004) <br /> <br />1872 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal TaX Lien <br /> <br />Area: Serial Number <br />WAGE &: INVESTMEN"T AREA #2, <br />Lien Unit Phone: {BOO} 829-7650 293982306 <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 rights to <br />- property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer FELICIANO DOMINGUEZ <br /> <br />For Optional Usa by Recording Office <br /> <br /> <br />9906455818-1 PIlS: 1 <br />DOMINGUEZ FELICIRNO <br />Filed: 06/05/200601:13 PM <br /> <br />Residence <br /> <br />1011 ST PAUL RD <br />GRAND JSLAND, NE 68801-3901 <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 cenificate of release as defihecf <br />in IRC 6325(a). <br /> <br />Kind of Tax <br />(a <br />1040 <br />1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/1997 <br />12/31/2000 <br /> <br />Identifying Number <br />c) <br />XXX-XX--'5252 <br />XXX-XX-5252 <br /> <br />Date of <br />Assessment <br />(d) <br />04/11/2005 <br />04/11/2005 <br /> <br />Last Day for <br />, Reflling <br />(e <br />05/11/2015 <br />05/11/2015 <br /> <br />Unpaid Balance <br />of Assessment <br />(0 <br />6426.90 <br />4623.18 <br /> <br />Place of Filing <br /> <br />Register' of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />T ota! $ <br /> <br />11050.08 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN' <br /> <br />, on this, <br /> <br />the <br /> <br />26th day of May <br /> <br />2006 <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829-7650 <br /> <br />12-00-0000 <br /> <br />for DEBRA K. HURST <br /> <br />(NOTE: Certificate of officer authorilsd by law to take acknowledgment is not essential to the validity of Notice of Federel Tax lien ~D <br />Rev. Ru!. 71 -466, 1971 - 2 C.B. 409) Form 66B(Y)(e) (Rev. 2-2004) , · <br />It,," t - K....t Bv Recording Offiee CAT. NO 60025X <br />