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<br />06/19/2007 TUE 15:16 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~006/006 <br /> <br />~~ Form 668 (Y)(c) <br />(Rev. February 2004) <br /> <br />12414 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />200705141 <br /> <br />Area: Serial Number <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829-7650 369766807 <br /> <br />As provided by section 6321, 6322, and 6323 of tbe Internal Revenue <br />Code, we are giving a notice chac taxes (inclUding inceresc and penalties) <br />have been assessed against the following-named taxpayer. .we have made <br />a demand for payment of chis liabllley, but it- remains unpaid. Therefore, <br />Cbere is a lien in favor of Che UniCed States on all property and rights to <br />properey belonging Co this taxpayer for - the amounC of these taxes, and <br />additional penalties, interest, and costs that may acerue. <br /> <br />Name of Taxpayer MIA HOUGH <br /> <br />For Optional Use bv Recording Office <br /> <br />1IIII11111I <br /> <br /> <br />9907514193-9 Pg$: 1 <br />~y~:~:M~/19/2007 12:36 PM <br /> <br />Residence <br /> <br />705 REDWOOD RD <br />GRAND ISLAND, NE 68803-3148 <br /> <br />IMPORTANT RlLEASE INFORMATION: For 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 /> Tax Period Identifying Number Date of Last Dal. for <br />Kind of Tax Ending Assessment Refllng <br />(a) (b) .(c) (d) (e) <br />CIVP 09/30/2001 XXX-XX-7433 02/14/2005 03/16/2015 <br />CIVP 12/31/2001 XXX-XX-743~ 02/14/2005 03/16/2015 <br />CIVP 09/30/2002 XXX-XX-7433 02/14/2005 03/16/2015 <br />CIVP 12/31/2002 XXX-XX-7433 02/14/2005 03/16/2015 <br />.CIVP 03/31/2003 XXX-XX-7433 02/14/2005 03/16/2015 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />2237.86 <br />2154.71 <br />2934.45 <br />2061.71 <br />862.08 <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 />10250.81 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />07 th day of June <br /> <br />2007 <br /> <br />the <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829-7650 <br /> <br />12-00-0000 <br /> <br />for DEBRA K. HURST <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax Iien- <br />Rev. Ru!' 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2.2004-) <br />Part 1 . Kept By Recording Office CAT. NO 60025X <br /> <br />\!-' <br />