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<br />08/07/2008 THU 13:30 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~002/004 <br /> <br />o'tFonn 668 (Y)(c) <br /> <br />4899 <br /> <br />Department of the Treasury- Internal Revenue Service <br /> <br />200806817 <br /> <br />Notice of Federal Tax Uen <br /> <br />~~N~&~~~e'" ,,~ ~tet. .John II Gale . ue, " <br />Area: Serial Number ~ Tl <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 459715808 <br /> <br />. ~:o:~ ~:n~~1;~~~ ~n~~~~n~~':: ....11111"" <br /> <br />have been assessed against the followinl"'named taxpayer. We have made ~9LLINS D~~i~ '" Pru: 1 <br />a demand for payment of this liability, but it remains unpaid. Therefore, lIed; 08/07/2008 09;36 AM <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 />addidonal penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer DENNIS M & REBECCA A COLLINS <br /> <br />(Rev. Februarv 2004) <br /> <br />Residence <br /> <br />1900 W PEACH CIR <br />LINCOLN, NE 68522-8719 <br /> <br />IMPORTANT RELEASE INFORMATION: Fo( 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 />1040 <br /> <br />Tax Period <br />. Ending <br />(b) <br />12/31/2005 <br /> <br />Identifyin, Number <br />(e) <br />XXX-XX-4730 <br /> <br />Date of <br />Assessment <br />(d) <br />09/18/2006 <br /> <br />Last D~y for <br />Rerding <br />(e) <br />10/18/2016 <br /> <br />Unpaid Balance <br />of Assessment <br />(0 <br />6203.75 <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 />6203.75 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />28th day of July <br /> <br />2008 <br /> <br />Signature <br /> <br />Title <br />REVENUE OFFICER <br />for STEVE MATTESON (319) 234-4481 <br /> <br />(NOTE: Certificate of officer authorized bv law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien V <br />Rev. Rul. 71-466, 1971 . 2 C.B. 4091 Form 668(Y)(c:) (Rev. 2.20041 \ <br />Part 1 . Kept By Rec:ordln, OffIce CAT. NO 60025X <br /> <br /> <br />24-10-1782 <br />