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<br />11/25/2008 TUE 14:03 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121004/004 <br /> <br />D<\) <br /> <br />Form 668 (Y)(c) <br />CRlv. February 20041 <br /> <br />8801 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 494424708 <br /> <br />As provided by section 6321, 6]22, and 6323 of the Intemal 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 righu to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may acerue. <br /> <br />Name of Taxpayer OSCAR ZAVALA <br /> <br />For Optional Use by Recording Office <br /> <br />.I~I'I ~fllllll ~In <br /> <br /> <br />9908577124-1 Pgs: 1 <br />ZRVRLR OSCRR <br />Filed: 11/25/2008 09:08 AM <br /> <br />Residence <br /> <br />706 POPLAR ST <br />GRAND ISLAND, NE 68801-0000 <br /> <br />200809739 <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 />1040 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/1999 <br /> <br />Identifying Number <br />(c) <br />XXX-XX-9014 <br /> <br />Date of <br />Assessment <br />(d) <br />05/06/2002 <br /> <br />Last Day for <br />Refiling <br />(e) <br />06/05/2012 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />11920.24 <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 />11920.24 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />14th day of <br /> <br />November 2008 <br /> <br />-, <br /> <br />for PATRICK J KELLOGG <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24-10-1744 <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. 409) Form 668(Y)(c) (Rev. 2.20041 <br />Part 1 . Kept By Recording Office CAT. NO 60025X <br /> <br />~ <br /> <br />-../ <br />