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<br />06/27/2006 15:38 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />141 0041005 <br /> <br />~ <br /> <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br /> <br />1872 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />200605746 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 297478006 <br /> <br />As provided by section 6321, 6322, and 632.3 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 LARRY L DECD .& MARLENE L JOHNSON <br /> <br />For Optional Use by Recording Office <br /> <br />111""1\' <br /> <br /> <br />9906459015-3 <br />JOHNSdON0L6Fl/~12~1ll~e;g~: 15 PM <br />File: . <br /> <br />Residence <br /> <br />507 ROUSH LN <br />GRAND ISLAND, NE 68801-2210 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed,below, <br />unless notice of the lien is refiled by the d'ate 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 /> <br />Kind of Tax <br />(a) <br />1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2003 <br /> <br />Identifying Number <br />(c) <br />XXX-XX-9869 <br /> <br />Date of <br />Assessment <br />(d) <br />04/03/2006 <br /> <br />Last Day for <br />Refiling <br />(e) <br />05/03/2016 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />350.06 <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 />350.06 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />the <br /> <br />15th day of June <br /> <br />2006 <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829-3903 <br /> <br />24-00-0008 <br /> <br />for REGINA OWENS <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Ru!. 71-466,1971 - 2 C.B. 409) Form 66B(Y)(c) ,(Rev. 2~2004l <br />Part 1 - Kept By RecordlnB Office CAT. NO 60025X <br /> <br />or <br />vl <br />~\ .- <br />