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<br />03/05/2007 MON 17:10 FAX 402 471 2530 secofstate/licensing div <br />20070-1702 <br /> <br />~ 007/008 <br /> <br />,'I <br /> <br />fJ <br /> <br />Form 668 (Y)(c) <br /> <br />12414 <br /> <br />Department of the Treasury - Internal Revenue Service <br />. Notice of Federal Tax Lien <br /> <br />(Rev. February 2004) <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Il'hone: {800} 913~6050 346804807 <br /> <br />As provided by se(oon 632., 6322, and 6323 of the Internal Revenue <br />Code, we are gMng a notice that taxes (including interest and penalties) <br />have been assessed apinst the followine-namedtaxpayer. We ha~e mad. <br />a demand for. payment of this liability, but it remains 'unpaid. Therefore, <br />che,re isa lien in favor of the United State~ on all property and rights to <br />. property belonging to ~i$ taxpayer for the amount of these taxes, and <br />, additional penalties, interest," and costs that may accrue. ' <br /> <br />Name of Taxpayer JOHN C MEYERS . <br /> <br />For QptiorJBI UBB by RE:c;ordlng Office <br /> <br /> <br />FTL <br /> <br />Pill: 1 <br /> <br />Residence <br /> <br />110.70 S BUFFALO'RD . <br />DONIPHAN,NE 68832-9721 <br /> <br />:t" <br /> <br />. ...... :~',,' "0';1. ...,T' <br /> <br />. '" ~ ~, -,: . r. "1" ,,", ~,. " "I":.;.c " <br /> <br />IMPORTANT kELEASE INFORMATION: FOreaoh<l$$essment listed below,;' <br />unless. notice of the lien isrefiled by the dEf\;egivenin .oolumn{(.h this notioe llhall, ,: <br />on the day tollowil"!Q . such date. operate ";i<s a',. certificate. of reletlse as, Ol;lfinElO' ~ <br />inlRC 832S(a}. .:. <br /> <br />. ~ > ;.:" i~~J ..,;:.,.~. '~-.I .... <br /> <br />\, , <br /> <br />.,....1'<. "" <br /> <br />Kind of Tax <br />(a) . <br />1040 <br /> <br />Tax Period <br />. ., Ending. :, <br />b <br />12/31/2002. . <br /> <br />Identifying Number: <br />(c <br />XXX~XX-'3:t72 <br /> <br />Date 'of <br />. Assessment , <br />(d.) <br />.05/22/2006 <br /> <br />Lase Ilq for <br />R~"ng. ~ <br />(e) <br />O'6/21/20l6' <br /> <br />Unpaid Balance <br />of Assessment. <br />(f) <br />554.23.74 <br /> <br />,.' <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 />55423.74 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this. <br /> <br />21st day of February <br /> <br />2007 <br /> <br />the <br /> <br />Signature <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24~10~2337 <br /> <br />for MICHAEL W PONTE <br /> <br />(NOT!; Certificate of officer authorize(1 by la~ to take acknowledgment Is r'IOt essential to the validity of Notic!;! of FMaral Tax lien .r \ \, <br />Rev. Rul. 71-466. 1971 - 2 C.6, 409) Form 668(Y)(c) (Rev. 2-2004) 'lU <br />Part 1 - Kept By Recording Offif;;e CAT. NO 60025X 'II <br />