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<br />04/16/2007 MON 15:26 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121004/004 <br /> <br />0% <br /> <br />Form 668 (Y)(C) <br />(Rev. FebrU'lrv 20041 <br /> <br />12414 <br />Department of the Treasury - Internal Revenue Service <br /> <br />Notice of Federal Tax Lien <br /> <br />200703059 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 355747007 <br /> <br />As provided 'by section 6321, 6322, and 6323 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, but it 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 TRACY A MARKHAM <br /> <br />For Optional Use by Recording Office <br /> <br />lnrrlrl'r~ :1 <br /> <br />9907e05507-5 p~s: 1 <br />MRRKHM TRACY A <br />Flled: 04/16/2007 03:00 PM <br /> <br />, <br /> <br />Residence <br /> <br />'16 VENUS ST <br />ALDA, NE 68810-9744 <br /> <br />IMPORTANT RELEASE INFORMATION: 'For each assessment listed below, <br />unless notice ot the lien is retiled 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 /> <br />Tax Period <br />Ending <br />(b) <br />09/30/2006 <br /> <br />Identifying Number <br />(e) <br />47-0845288 <br /> <br />Date of <br />Assessment <br />(d) <br />02/05/2007 <br /> <br />Last D~ for <br />Refiling <br />(e) <br />03/07/2017 <br /> <br />Unpaid Balance <br />of Assessment <br />(0 <br />2719.81 <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 />2719.81 <br /> <br />This notice was prepared and signed at <br /> <br />ST. PAUL, MN <br /> <br />, on this, <br /> <br />03rd day of April <br /> <br />2007 <br /> <br />the <br /> <br />Signature <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24-10-2341 <br /> <br />for PAT KELLOGG <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax. lien <br />Rev. Ru!' 71-466, 1971 - 2 C.B. 4091 Form 668(Y)(c) IRev. 2-20041 <br />Part 1 . Kept By Recording Office CAT. NO 60025X V <br />