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<br />10/19/2006 14:40 FAX 14024714429 <br /> <br />NEBRi\SKA vee . <br /> <br />jJ <br /> <br />Form 668 (Y)(c) <br />(Rev. February 20041 <br /> <br />l075 <br /> <br />~ 002/005 <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: (BOO) 913-6050' 322046106 <br /> <br />As provided by section 632 t, 6322, and 6'323 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, ~ut it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />property bel!)nging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer LESLIE A OTTMAN <br /> <br />Residence <br /> <br />122 E 11TH ST <br />GRAND ISLAND, NE 68801-3806 <br /> <br />1~!nmII;1111111 <br /> <br />9906475820-0 PSI: 1 <br />OTl1'Ii=lN LESLIE i=l <br />FLl_d: 1111/19/2006 08:37 AM <br /> <br />'200609370 <br /> <br />IMPORTANT RELEASE INfORMATION: Far 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 />941 <br />941 ' <br />941 <br />941 <br />941 <br />941 <br />941 <br /> <br />Tax Period <br />Ending <br />(b) <br />03/31/2004 <br />06/30/2004 <br />09/30/2004 <br />12/31/2004 <br />03/31/2005 <br />06/30/2005 <br />12/31/2005 <br /> <br />Date of <br />Assessment <br />(d) <br />06/26/2006 I <br />06/05/2006 <br />06/26/2006 <br />06/26/2006 <br />06/26/2006 <br />06/19/2006 <br />06/19/2006 <br /> <br />Identifying Number <br />(c) <br />39-1901743 <br />39-190l743 <br />39-1901743 <br />39-1901743 <br />39-190l743 <br />39-1901743 <br />39-1901743 <br /> <br />Place of Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68.802-1692 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN' <br /> <br />, on thi5~ <br /> <br />the <br /> <br />12th day of October <br /> <br />2006 <br /> <br />Signature <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308), 384-4850 <br /> <br />24-l0-2341 <br /> <br />for PAT KELLOGG <br /> <br />Last Day for <br />Refilmg <br />(e) <br />07/26/2016 <br />07/05/2016 <br />07/26/20l6 <br />07/26/2016 <br />07/26/2016 <br />07/19/20l6 <br />07/l9/2016 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />1822~89 <br />2141. 23 <br />18l0.20 <br />2081.08 <br />1698.83 <br />20l9.94 <br />223.47 <br /> <br />Total $ <br /> <br />11797.64 <br /> <br />(NOTE: Cenificate of officer authoriz.ed by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Ru!. 71466,1971 - 2 C.B. 409) Form 668(Y)(C) (Rev. 2-2004) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br /> <br />rP <br />