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<br />09/18/2006 16:34 FAX 14024714429 <br /> <br />NEBRASKA Dee _ <br /> <br />Igj 003/003 <br /> <br />rS <br /> <br />1872 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />Form "8 (Y)(e) <br />(Rev. FebrulIry 2004) <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 315540306 <br /> <br />As provided by section 632 t, 6322, and 6323 of the Internal Revenue <br />Code, we are living 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 Oen 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 />addidonal penaldes, interest, and costs that may accrue. <br /> <br />Name at Taxpayer JASON C LAWHORNE <br /> <br />For Optional Use by Recording Office <br /> <br />IlrlllllrlU <br /> <br />9906470756-8 pgs: 1 <br />LAWHORNE JRSON C <br />Fil_dl 09/18/200601:40 PM <br /> <br />Residence <br /> <br />2203 E HIGHWAY30 <br />GRAND ISLADN, NE 68801-9400 <br /> <br />200608369 <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 />(al <br />1040 <br />1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2002 <br />12/31/2003 <br /> <br />Identifying Number <br />(e) <br />XXX-XX-0229 <br />XXX-XX-0229 <br /> <br />Date of <br />Assessment <br />(d) <br />03/27/2006 <br />03/27/2006 <br /> <br />Last Day for <br />Refding <br />eel <br />04/26/2016 <br />04/26/2016 <br /> <br />Unpaid Balance <br />of Assessment <br />(n <br />18687.25 <br />81215.6'3 <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 />99902.88- <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, JIlIN <br /> <br />, on this, <br /> <br />the <br /> <br />Oath day of <br /> <br />September 2006 <br />, <br /> <br />for MICHAEL W PONTE <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24-10-2337 <br /> <br />Signature <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. Rut 71-466,1971 - 2 C.B. 409) Form 66B(Y)(e) (Rev. 2-20041 ,,( <br />Part 1 . Kept By Reconfinl Office CAT. NO 60025X \. .J)' <br />