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<br />09/16/2008 TUE 14:20 <br /> <br />(jJ <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />1210021004 <br /> <br />4653 <br /> <br />Form 668 (Y)(c) <br />IRev. February 20041 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien 20 0 8 0 7 9 64 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 470722)08 <br /> <br />As provided by section 6]21, 6]22, 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 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 NORMA C MORENO <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />FTL <br /> <br />pgs: 1 <br /> <br />Residence <br /> <br />107 CENTENNIAL DR <br />GRAND ISLAND, NE 68801-0000 <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 />Kipd of Tax <br />(a). <br />941 <br />941 <br /> <br />Tax Period <br />Ending <br />(b) <br />03/31/2007 <br />12/31/2007 <br /> <br />Identifying Number <br />c <br />68-0580063 <br />68-0580063 <br /> <br />Date of <br />Assessment <br />(d) <br />04/07/2008 <br />03/31/2008 <br /> <br />Last Day for <br />Reflling <br />(e) <br />05/07/2018 <br />04/30/2018 <br /> <br />Unpaid Balance <br />of Assessment <br /> <br />4924.07 <br />2652.18 <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 />7576.25 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />05th day of <br /> <br />September 2008 <br />, <br /> <br />Signature <br /> <br />Title <br />REVENUE OFFICER <br />for PAT KELLOGG (308) 384-4850 <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. Ru!' 71-466, 1971 - 2 C.B. 409) Form 668OO(d (Rev. 2-2004) \0 <br />Part f . Kept By Recording Office CAT. NO 60025X ~ <br /> <br /> <br />24-10-2341 <br />