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<br />03/10/2009 TUE 13:33 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121003/005 <br /> <br />o~ <br /> <br />"."~" <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) 829-3903 520196309 <br /> <br />As provided by section 632 t, 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 CHARLENE LEVERING <br /> <br /> <br />9909589388-5 Pss: 1 <br />LEVERING CHARLENE <br />Filed: 03/10/2009 10:56 AM <br /> <br />Fo' NE s.c; tit 'State .Jghn FIl Gale.. UCC <br /> <br />Residence <br /> <br />1202 SAINT PAUL RD <br />GRAND ISLAND, NE 68801-3804 <br /> <br />200901772 <br /> <br />. . ~... . <br /> <br />IMPO.RTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the Ii~n 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 />,.';..,-jft...':;;.:.... : <br />.-;r,:'''''':.,~ : <br /> <br />.,'.' .j <br /> <br /> Tax Period Date of Last D'}T. for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Reft Ing of Assessment <br />(a) b) (c (d) e (0 <br />1040 12/31/2000 XXX-XX-2290 04/23/2007 OS/23/2017 3922.88 <br />1040 12/31/2002 XXX-XX:O-2290 04/23/2007 OS/23/2017 4322.61 <br />1040 12/31/2003 XXX-XX-2290 04/23/2007 OS/23/2017 4657.54 <br /> <br />,- <br />," <br /> <br />... '<':i~~~~ ;": <br />...~'1 :, <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 />12903.03 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO,IL <br /> <br />, on this, <br /> <br />the <br /> <br />25th day of February <br /> <br />2009 <br /> <br />Signature <br /> <br />Title <br />ACS <br />for MICHAEL W. COX (800) 829-3903 <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. Ruf. 71~466. 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-20041, . ..,,~~oo," <br />. Part 1 . Kept By Recording Office CAT. NO 60025X . .. :~ : <br /> <br /> <br />24-00-0008 <br />