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<br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121003/004 <br /> <br />4653. <br /> <br />Department of the Treasury - Internal Revenue Service <br /> <br />Notice of Federal Tax Lien <br /> <br />200708471 <br /> <br />Area: Serial Number For Optional Use by Recording Office <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829-7650392775407 <br /> <br />As 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 followinl"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, and <br />additional penalties, interest, and .costs that may accrue. <br /> <br />Name of Taxpayer JAMES MCGUIRE III <br /> <br /> <br />Residence <br /> <br />522 W 1ST ST <br />GRAND ISLAND, NE 68801-5803 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessnl!ilnt listed below, <br />unless notice of the lien is reWed by the date given in column (0), 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 />(d <br />:1,040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2004' <br /> <br />Identifying Number <br />c <br />XXX-XX-7445 <br /> <br />Date of <br />Assessment <br />(d) <br />02/28/2005 <br /> <br />La$t Day for <br />Refiling <br />(el <br />03/30/2015 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />5112.59 <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 />5112.59 <br /> <br />This notice was prepared and signed at <br /> <br />ST'PAUL, MN <br /> <br />, on this, <br /> <br />20th day of <br /> <br />September 2007 <br />, <br /> <br />the. <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829-7650 <br /> <br />'12-00-0000 <br /> <br />for, DEBRA K. HURST <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is. not essential to the validity of Notice of Federal Tax lien (jJ <br />Rev. Ru!' 71-466,1971.2 C.B. 409) Form 668(Y)(c) (Rev. 2-20041 . <br />, Part 1 . Kept By Recording Office, CAT. NO 60025X ' <br />