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<br />10/03/2006 16:37 FAX 14024714429 <br /> <br />~ <br /> <br />Form 668 (Y)(c) <br /> <br />{Rev. February 20041 <br /> <br />1075 <br /> <br />NEBRASKA Dee <br /> <br />IaJ 009/009 <br /> <br />200608915 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />For Optional Use by Recording Office <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 318698206 <br /> <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (jncludlnrlnterest and penalties) <br />have been assessed against the followin,~named taxpayer. We have made <br />a demand for payment of this liability, but k 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 THOMAS A WAGONER <br /> <br />Residence <br /> <br />1819 W NORTH FRONT S.T <br />GRAND ISLAND, NE 68803-4706 <br /> <br />\\\\\111\\\1\\1\\\"'\\\\ <br /> <br /> <br />9906473404-6 ps . <br />WAGONER1T0H/00~A/S2~6 03-00 PM <br />Fil_d, ~ . <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 IRC 6325(8). <br /> <br />Kind of Tax <br />(a) <br />940 <br />940 <br />940 <br />940 <br />940 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br /> <br />Place of Filing <br /> <br />Tax. Period <br />Ending <br />(b) <br />12/31/1996 <br />12/31/1997 <br />12/31/1998 <br />12/31/1999 <br />12/31/2001 <br />12/31/1997 <br />03/31/1998 <br />06/30/1998 <br />12/31/1998 <br />03/31/1999 <br />06/30/1999 <br />12/31/1999 <br />03/31/2000 <br /> <br />Identifying Number <br />(cl <br />47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0SS0792 <br />" 47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0550792 <br />47-0550792 <br /> <br />Date of <br />Assessment <br />(d) <br />09/15/1997 <br />09/21/1998 <br />11/08/1999 <br />06/05/2000 <br />11/25/2002 <br />09/21/1998 <br />11/16/1998 <br />12/14/1998 <br />11/08/1999 <br />11/15/1999 <br />03/13/2000 <br />06/05/2000 <br />10/18/2000 <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />Last Day for <br />ReOlin, <br />(e) <br />10/15/2007. <br />10/21/2008 <br />12/08/2009 <br />07/05/2010 <br />12/25/2012 <br />10/21/2008 <br />12/16/2008 <br />01/13/2009 <br />12/08/2009 <br />12/15/2009 <br />04/12/201.0 <br />07/05/2010 <br />11/17/2010 <br /> <br />Unpaid Balance - <br />of Assessment <br />(f) <br /> <br />18.07 <br />17.79 <br />18.92 <br />12.70 <br />18.21 <br />267.00 <br />245.48 <br />204.95 <br />283.87 <br />232.85 <br />145.83 <br />157.42 <br />93.41 <br /> <br />Total $ <br /> <br />1716.50 <br /> <br />, on this. <br /> <br />the . "22nd day of september, 2006 <br /> <br /> <br />Title <br />REVENUE OFFICER <br />for BILL. HOUSE (308) 532-7510 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment i5 not assential to the validity of Notica of Federal Tax lien <br />Rev. Rul. 71-466, 1.971 - 2 C.B. 409) Form 668(Y)(c;) (Rev. 2-2004) <br />P..... 1 _ It_t- Rv R_....din.. nffl... -. - ..- ~.........r" <br /> <br />Signature <br /> <br />24-10-2336 <br /> <br />cp <br />