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<br />09/11/2007 TUE 15:38 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121004/007 <br /> <br />.ro <br />o <br /> <br />1924 <br /> <br />Foam 668 (Y)(c) <br />(Rev. February 20041 <br /> <br />. Department of the Treasury - Internal Reyenue Service <br />Nodce of Federal Tax Lien <br /> <br />Area~ Serial Number <br />S~L BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 38B019307 <br /> <br />/U provided by section 612 t, 6322, and 6121 of the Internal Revenue <br />.Code, we are giving a notice that taxes (including interest an.d penalties) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpajd. 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 JOEL B SHAFER <br /> <br />For Optional Use by Recording Office <br /> <br />1[11I'1~"(n;n <br /> <br /> <br />9907524979-7 PllS: 1 <br />SHRFER JOEL. B <br />Filed: 09/11/2007 09:22 AM <br /> <br />Residence <br /> <br />6f; PONDEROSA DR <br />GRAND ISLAND, NE 68803-9673 <br /> <br />20070'7851 <br /> <br />. . <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 />Kind of Tax <br />(a) <br />1040 <br /> <br />Tax: Period <br />Ending <br />(b) <br />12/31/2003 <br /> <br />Identifying Number <br />(el <br />XXX-XX-067S <br /> <br />. Date of . <br />Assessment <br />(d) <br />11/15/2004 <br /> <br />Last Day for <br />Refiling <br />(e) <br />12/15/2014- <br /> <br />Unpaid. Balance <br />of Assessment <br />(f) <br />10043.03 <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 />10043.03 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />30th day of Augus t <br /> <br />2007 <br /> <br />the <br /> <br />Signature <br /> <br />Title <br />ACS <br />for REGINA 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 Federa"1 Tax lien rjJ <br />Rev. Rul. 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 />24-00-0008 <br />