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<br />03/02/2009 MQN 11:48 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121 003/006 <br /> <br />('\ <br />U <br /> <br />8801 <br /> <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br /> <br />Department of the Treasury -Internal Revenue Service <br /> <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 518682009 <br /> <br />As provided by section 6321, 6322, 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 RONALD L BURES <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />9909588450-7 PS$' 1 <br />BURES RONALO L <br />Filed, 03/02/2009 10,04 AM <br /> <br />Residence <br /> <br />1108 S SYCAMORE <br />GRAND ISLAND" NE 68801-0303 <br /> <br />200901537 <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 /> Tax Period Date of Last Dal. for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refi 109 of Assessment <br />(a) b) (c) (d) (e) - f <br />1040 12/31/2001 XXX-XX-1069 06/03/2002 07/03/2012 2572.99 <br />1040 12/31/2002 XXX-XX-1069 06/02/2003 07/02/2013 16946.22' <br />1040 12/31/2003 XXX-XX-I069 OS/24/2004 06/23/2014 6324.94 <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 />25844.15 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />19th day of February <br /> <br />2009 <br /> <br />Signature <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24-10-1739 <br /> <br />for WILMA K PONTE <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. 4091 .' Form 668(Y)(c) (Rev. 2-200M1~~\J <br />Part I - Kept By Recordmg Office CAT. NO 60025XC ~I <br />\..... <br />