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<br />07/17/2007 TUE 15:43 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~005/005 <br /> <br />O'\orm 668 (Y)(c) <br />(Rev. Februarv 20041 <br /> <br />3464 <br /> <br />Department of the Treasury - Internal Revenue Service <br /> <br />Notice of Federal Tax Lien <br /> <br />. Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 376329107 <br /> <br />AJ provided by section 6321,63.22, 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 fc>lIowing-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, arid <br />additional penalties, interest, and costs that may accrue. <br /> <br />Nanie of Taxpayer JAMES A MATSON <br /> <br />For Optional Use by Recording Office <br /> <br />Illrnrrll~~ I <br /> <br />9907517671-6 Pgs" 1 <br />MATSON JAMES A " <br />Filed: 07/17/2007 02,45 PM <br /> <br />Residence <br /> <br />3090 W 2ND ST <br />GRAND ISLAND, NE 68803-5264 <br /> <br />200706069 <br /> <br />IMPORTANT RELEASE 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 IRC. 6325(a). <br /> <br />..,.. ,~ . <br /> <br />...; .. <br /> <br />Kind of Tax <br />(a) . <br />940 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2006 <br /> <br />Identifying Number <br />(c) <br />81-0640267 <br /> <br />Date of . <br />AJsessment <br />(d) <br />04/30/2007 <br /> <br />Last D!IY for <br />Refding <br />(e) <br />05/30/2017 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />425.78 <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 />425.78 <br /> <br />. <br /> <br />. This notice was. prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on thiS, <br /> <br />the <br /> <br />06th day of July <br /> <br />2007 <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 />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B.A09) Form 668(Y)(c) (Rev. 2-2004) <br />Part t . Kept By Recording Office CAT. NO 60025X <br /> <br />'i/" . <br />