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09/07/2007 FRI 14:44 FAX 402 471 4429 UCC SECRETARY OF STATE - -- Hall <br />IM002/002 <br />J <br />This notice was prepared and signed at <br />the 28th day of August 2007 <br />ST PAUL, MN <br />, on this, <br />Signature A Title <br />ACS 24--00 -0008 <br />for REGINA OWENS (800)829 -3903 <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.R. 409) Form 668(Y)(c) (Rev. 2 -2004) <br />Part i - Kept By Recording Office CAT. NO 60025X Y� <br />4653 <br />Department of the Treasury - Internal Revenue Service. <br />F°"" 66$ (Y)(`) <br />Notice of Federal Tax Lien 200707741 <br />(Rev. February 2004) <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone_ ($00) 829 -3903 <br />387370807 <br />NM sec of Si ale Jahn A Osir - yCC FYL <br />As provided by section 8321, 6322, and 6323 of the internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a . demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />eae7sz462i_e peg: f <br />property belonging to this taxpayer for the amount of these taxes, and <br />DAVIDSON KATHY C 11:24 AM <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer KATHY C DAVIDSON <br />Residence 312 WYANDOTTE ST APT 3 <br />GRAND ISLAND; NE 68801 -7693 <br />ELEASE INFORMATION: For each assessment listed below, <br />he lien. is refiled by the date given in column (e), this notice shall, <br />=C6 <br />ing such date, operate as a certificate of release as defined <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refilling <br />of Assessment <br />(a) <br />(b) <br />c <br />d <br />e <br />(f) <br />1040 <br />12/31/2002 <br />XXX -XX -8675 <br />06/23/2003 <br />07/23/2013 <br />255.79 <br />1040 <br />12/31/2003 <br />XXX -XX -8675 <br />05/31/2004 <br />06/30/2014 <br />857.72 <br />104.0 <br />12/31/2005 <br />XXX -XX -8675 <br />05/08/2006 <br />06/07/2016 <br />2277.05 <br />1040 <br />12/31/2006 <br />XXX -XX -8675 <br />05/28/2007 <br />06/27/2017 <br />2430.81 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 5821.37 <br />Grand Island, NE 68802 -1692 <br />J <br />This notice was prepared and signed at <br />the 28th day of August 2007 <br />ST PAUL, MN <br />, on this, <br />Signature A Title <br />ACS 24--00 -0008 <br />for REGINA OWENS (800)829 -3903 <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.R. 409) Form 668(Y)(c) (Rev. 2 -2004) <br />Part i - Kept By Recording Office CAT. NO 60025X Y� <br />