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<br />04/08/2009 WED 15:55 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />1ilI003/009 <br /> <br />& <br />Form 668 (Y)(c) <br />(Rev. February 20041 <br /> <br />8801 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />~~~~sE~~i:S ~11;;j;j" <br /> <br /> <br />a demand for payment of this liability, but it remains unpaid. Therefore, ~~~~~~~~~~NPSS: 1 <br />there is a Oen In favor of the United States on all property and rights to F!Jed: 04/0a/2009J~1' 19 AM <br />property belongin, to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer RAMON CABALLERO JR <br /> <br />Residence <br /> <br />2903 W STOLLEY PARK RD <br />GRAND ISLAND, NE 68801-6868 <br /> <br />200902607 <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 632!?(a). <br /> <br />,- <br /> <br />L <br /> <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br /> <br />Tax Period <br />Endin, <br />(b) <br />12/31/2006 <br />12/31/2006 <br /> <br />Identifyln, Number <br />(c) <br />XXX-XX-5660 <br />XXX-XX-5660 <br /> <br />Date of <br />Assessment <br />(d) <br />04/15/2007 <br />06/30/2008 <br /> <br />Last D~ for <br />Refilin, <br />(e) <br />05/15/2017 <br />07/30/2018 <br /> <br />Un~aid Balance <br />of Assessment <br />(I) <br /> <br />3204.78 <br /> <br />i' <br /> <br />~ ...' <br /> <br />. . <br />,. <br />! <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 />3204.78 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />26th day of March <br /> <br />2009 <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829-7650 <br /> <br />12-00-0000 <br /> <br />for DEBRA K. HURST <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. 2-2004) \1/ <br />Part I . Kept By Recordln, OffIce CAT. NO 60025X t" <br />