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<br />08/16/2007 THU 15:53 <br /> <br />~ <br /> <br />Form 668 (Y)(C) <br />(Rev. FllbrlJ8ry 2004) <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />1dI003/003 <br /> <br />1924 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />200707047 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/Sm:..F EMPLOYED AREA #4 <br />Lien Unit Phone: (800} 829-3903 383059107 <br /> <br />As provided by seaion 6321, 6322, and 6323 of die Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalti~) <br />have been assessed against the followin,..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 pmperty and rights to <br />property belonging to this ~yer for the amount of these taxes, and <br />additional penalties. Interest, and costs that may' accrue. <br /> <br />Na~e of Taxpayer JAY B JUDDS <br /> <br />For 0 tional Use by Recording Ottice <br /> <br /> <br />Residence <br /> <br />2735 BRENTWOOD BLVD <br />GRAND ISLAND, NE 68801-7272 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is fi;!filed by the date- given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release all defined <br />in IRC 6325(a). - <br /> <br />Kind of Tax <br />a <br />1040 <br /> <br />Tax Period <br />ElIding <br />(b) <br />12/31/2003 <br /> <br />Identifyin, Number <br />c <br />XXX-XX-6893 <br /> <br />Date of <br />AsseSsment <br />d <br />12/18/2006 <br /> <br />LaSt Day for <br />, Refilinl <br />e <br />01/17/2017 <br /> <br />Unpaid Balance <br />of Assessment <br />( <br />29985.91 <br /> <br />Place 0.1 Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />Total $ <br /> <br />29985.91 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />07 th day of Augus t <br /> <br />2007 <br /> <br />the <br /> <br />Signature <br /> <br />Title <br />ACS <br />for REG!NA OWENS (800) 829-3903 <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. 409) ..' ' Form 668(Y)(c) (Rev. 2'2004)~ <br />. Part 1 . Kept By RecordiDI Office CAT. NO 60025X <br />. . ~ <br /> <br /> <br />24-00-0008 <br />