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<br />NEBRASKA Dee <br />I <br />I <br />I <br /> <br />IaJ 0021003 <br /> <br />02/27/2007 10:05 FAX 14024714429 <br /> <br />"'\ <br />i~ <br /> <br />\J -Form 668 -(Y)(C) <br />(Rev. February 2004) <br /> <br />l2414 <br /> <br />i <br />Department of the Trclasury - Internal Revenue Service <br />I . <br />Notice of federal Tax Lien <br />I <br /> <br />200701478 <br /> <br />Area: <br />WAGE & INVESTMENT AREA #2 : <br />Uen Unit Phone: (800) 829-7650 I 346296307 <br /> <br />As provided by section 6311, 6311, and 6313 of tt$! internal Revenue <br />Code, we are giving a notice that taXes (including int~rest and penalties) <br />have been assessed against the following.named taxpayer ~ We have made <br />a demand for payment of this liability, but it remainsi unpaid. Therefore, <br />there is a lien in favor ,of the United States on' all property and rights to <br />property belonging to this taxpayer for the amou.,t of these taxes, and <br />additional penalties, interest, and costs that may acclfue. <br /> <br />Name of Taxpayer ANTONIO T TREJO <br /> <br />Serial Nilimber <br /> <br />For Optional Use by Recording Office <br /> <br />1111"/'J~111I1 <br /> <br /> <br /> <br />T~EJO ANTONIO T PS$' 1 <br />Fl1.d; 02/26/2007 10:22 RM <br /> <br />Residence <br /> <br />1414 E 5TH ST <br />GRAND ISLAND, NE 68801-2~10 <br /> <br />, " <br />IMPORTANT RELEASE INFORMATION: For each as~essment 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 1'1 release as defined: <br />in IRC 6325(a). I <br />I <br /> <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2002 <br />12/31/2004 <br /> <br />IdentifYing Number <br />ic) <br />XXX':'XX- 5518: <br />XXX-XX-5518 '- <br /> <br />I <br />i Date of <br />Assessment <br />j Cd) <br />051/23/2005 <br />05i/23/2005 <br /> <br />Last Day for <br />Retiling <br />(e) <br />06/22/20,15 <br />06/22/201'5 <br /> <br />, : t <br />Unpaid Ba~nce <br />of Assess~ent <br />(f) ! <br />5464.90- <br />474.60, <br /> <br />, <br />, <br />. ~ <br />, <br />I <br />, I <br /> <br />Place of Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 ! <br />Grand Island, NE 68802~l692 <br /> <br />Total $ <br /> <br />I <br />I <br />! <br />i <br />I <br />5939.50 <br />I <br /> <br />This notice was prepared and signed at <br /> <br />I <br />I <br />ST PAUL, MN <br /> <br />I ' <br /> <br />, on this, <br /> <br />the <br /> <br />16th day of <br /> <br />February 2007 <br /> <br />, .. <br /> <br />- i <br /> <br />, r <br />Signature ~!!. "/'l~ -j-;;-11R~ ATictlse <br />~} In _ 12-100-0000 <br />for DEBRA K. HURST , (800) 829-7650 - -, <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal ;TBX lien <br />Rev. Rul. 71-466. 1971 .2 C.B. 409) ; I Form 668(Y)(c) (I ev. 2.2004) (\0 <br />Part 1 . K_t B~ R.ecordlnl',Office CAT: ~O 60025X ,,"1:( <br />