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12/23/2008 TUE 14:26 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall 121007/007 8801 Q Form 668 (Y)(c) . (Rev. February 20041 Department of the Treasury. Internal Revenue Service Notice of Federal Tax Lien 200810361 Area: Serial Number SMALL BUSINESS/SELF EMPLOYED AREA #1 Lien Unit Phone: (800) 913-6050 500478908 As provided by section 632 t, 6322, and 6323 of the Internal Revenue Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the following-named taxpayer. We have made a demand for payment of this liability, but it remains unpaid. Therefore, there isa lien in favor of the United States on all property and rights to property belonging to this taxpayer for the amount of these taxes, and additional penalties, interest, and costs that may accrue. Name of Taxpayer BRIAN F PATTEN For Optional Use by Recording Office \\\\11'\111\"" 9908580275-5 ?ATTEdN B1R21/~~/;00B 01 ;1ll6 PM File: Residence 664 FAIDLEY PLACE APT 4 GRAND ISLAND, NE 68803-3436 IMPORTANT RELEASE INFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column (e), this notice shall, on . the day' following such date, operate as a certificate of release as defined in IRC 6325(a). Kind of Tax (a) 1040 Tax Period Ending (b) 12/31/2007 Identifying Number (c) XXX-XX-3755 Date of Assessment (d) 07/14/2008 Last Day for Refillng (e) 08/13/2018 Unpaid Balance of Assessment (f) 5748.50 Place of Filing Register of Deeds Hall POBOX 1692 Grand Island, NE 68802-1692 Total $ 5748.50 This notice was prepared and signed at CHICAGO, IL , on this, the 09th day of December. 2008 Signature Title CASE PROC MGR for PEGGY D'AMICO _ (866) 611-6191 (NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev. Rul. 71.466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-2004) Part 1 ., Kept By Recording OffIce CAT. NO 60025X 21-00-0018 \;