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<br />09/19/2007 WED 15:29 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~003/003 <br /> <br />D~ <br /> <br />Form 668 (Y)(c) <br />IRev. Februarv 2004) <br /> <br />4653 <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 U,nit Phone: (800) 913-6050 389554807 <br /> <br />AJ provided by section 6321, 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 6en 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 JAMES A MATSON <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />n~ <br /> <br />9907526231-5 Pgs, 1 <br />MATSON JAMES A <br />Filed: 09/19/2007 02:49 PM <br /> <br />Residence <br /> <br />3090 W 2ND ST <br />GRAND ISLAND, NE 68803-5264 <br /> <br />200708104 <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 IRe 6325(a). . <br /> <br />Kind of Tax <br />a <br />941 <br /> <br />Tax Period <br />Endinr <br />b <br />03/31/2007 <br /> <br />. Identifying Number <br />c <br />81-0640267 <br /> <br />Date of <br />AJsessment <br />d <br />07/02/2007 <br /> <br />Last DM for <br />Refiling <br />(e) <br />08/01/2017 <br /> <br />Unpaid Balance <br />of Assessment <br /> <br />768.28 <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 />768.28 . <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 <br /> <br />September 2007 <br />, <br /> <br />for MICHAEL W PONTE <br /> <br /> <br />Title . <br />REVENUE OFFICER <br />(308) 384-4850. <br /> <br />24-10-2337 <br /> <br />Signature <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. 4091 <br /> <br />Part t - Kept By Recording Office <br /> <br />Form 668(Y)(c) (Rev. 2.20041 <br />CAT. NO 60025X <br /> <br />'1-. <br />