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<br />12/27/2006 18:09 FAX 14024714429 <br /> <br />NEBRASKA uee <br /> <br />IaI 002 <br /> <br />() <br /> <br />1671 <br /> <br />Department of the Treasury - Internal Revenue Service <br />'Notice of Federal Tax Lien <br /> <br />200611485 <br /> <br />Form 668 (Y}(c) <br />(Rev. February 2004) <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA ~4 <br />Lien Unit Phone: (800) 913-6050 334079506 <br /> <br />N provided by section 632 i, 6322, and 6323 of the Internal Revenue <br />Code, we are giv.ing 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 belongine to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer DOMINGO TERCERO RAMIREZ <br /> <br />For Optional Use by Recording Office <br /> <br />\ \\(11\(1""1'1 <br /> <br />9986486943-3 ; <br />DOMINGO TERCERO.RAM03I~g~ PM <br />Fll_d: 12/2712006 . <br /> <br />Residence <br /> <br />PO BOX 864 <br />GRAND ISLAND, NE 68802 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (9), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in l,Re 6325(a). <br /> <br />Kind of Tax <br />eal <br />,1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2002 <br /> <br />Identifying Number <br />(c) <br />XXX-XX-01S4 <br /> <br />Date of <br />Assessment <br />(d) <br />11/01/2004 <br /> <br />. Last Dg for <br />Rerdinr <br />(e) <br />12/01/2014 <br /> <br />Unpaid Balance <br />of Assessment <br />(I) <br />7502.12 <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 />7502.12 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL I MN <br /> <br />, on this, <br /> <br />the <br /> <br />13 th day Of December <br /> <br />2006 <br /> <br />Signature <br /> <br />Title <br />ACS <br />for R. RAY JOHNSON (800) 829-7650 <br /> <br />. (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien cf <br />Rev. Rut. 71-466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-20041" . . <br />, Pare 1 . Kept By Recording Offiu CAT. NO 60025X <br /> <br /> <br />15-00-0000 <br />