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<br />12/04/2007 TUE 15:21 <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br />-200710186 <br /> <br />1dI006/006 <br /> <br />--~ <br />\'i <br /> <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 405196707 <br /> <br />As provided by section 6321, 6322, and 6323 of che Internal Revenue <br />Code, we are giving a nodce that taxes (including Interest and penalties) <br />have been assessed against the foUowinl"named taxpayer. We have made <br />I demand for payment of this liability, but It remains - unpaid. Therefore, <br />there is a lien In favor of che United States on all property and ripcs to <br />property belonging to this taxpayer for the amount ofdlese taxes, and <br />addidonal penaldes, interest, and costs that may aecrue. <br /> <br />Name of Taxpayer BRIAN F PATTEN <br /> <br />For Optional Use by ~ecording Office <br /> <br />\1111111'" <br /> <br /> <br />9907536646-6 PllS - - <br />~~I~~ ~~~~/~007 02:24 PM <br /> <br />- <br /> <br />Residence <br /> <br />664 FAIDLEY PL APT 4 <br />GRAND ISLAND, NE 68803-3436 <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 />I ;: <br /> <br /> Tax Period Date of Last D1t.for <br />Kind of Tax Ending Identifying Number -Assessment ~)I <br />Cal Cb) Ce) Cd) <br />1040 12/31/2000 XXX-XX-3755 0-8/27/2007 " 09/26/2017 <br />1040 12/31/2001 XXX-XX-3755 09/11/2006 10/11/2016 <br />1040 12/31/2005 XXX-XX-3755 08/20/2007 09/19/2017 <br /> <br />Unpaid Balance <br />of AsSessment <br />CI) <br />"10290.73 <br />15292.64 <br />9873.25 <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 />35456.62 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL I J.VIN <br /> <br />, on this, <br /> <br />the <br /> <br />21st day of November <br /> <br />2007 <br /> <br />Signature <br /> <br /> <br />Title <br />ACS- <br />(800) 829-7650 <br /> <br />14-00-0000 <br /> <br />for R. RAY JOHNSON <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of F. ederal-Tax lien ~ <br />Rev. Rul. 71-466,1971 - 2 C.B.4091 . Form 66BOO(c) (Rev. 2-2004) <br />- Part 1 - Kept By Recordilll Office - CAT. NO 60025X <br />