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<br />04/08/2009 WED 15:56 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />14lI0 0 6/ 0 0 9 <br /> <br />Q% <br /> <br />Form 668 (Y}(c) <br />IRov. FobNory 2004) <br /> <br />8801 <br /> <br />Department of the Treasury. Internal Revenue Service <br /> <br />Notice of Federal Tax Lien <br /> <br />Area: Serial Number <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829-7650 529535709 <br /> <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are Bivin, a notice that taxes (including interest and penalties) <br />have been assessed alllnst the followlnl"'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 belonslng to this taxpayer for the amount of these taxes, and <br />additional penalties, Interest, and costs that may accrue. <br /> <br />Name of Taxpayer MARY JEAN MOHNlKE <br /> <br /> <br />HL <br /> <br />9909592725-6 Pes' 1 <br />MOHNIKE MARY JEAN <br />Filed: 04/08/2009 11:19 AM <br /> <br />Residence <br /> <br />1319 PARK AVE <br />GRAND ISLAND, NE 68803-3044 <br /> <br />2009026.10 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien Is refiled by the date given in column Ie), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(8). ' <br /> <br />Kind of Tax <br />,(a) <br />1040 <br />1040 <br /> <br />Tax Period <br />Ending <br />(b <br />12/31/2000 <br />12/31/2002 <br /> <br />Identifying Number <br />c) <br />XXX-XX-5239 <br />XXX-XX-5239 <br /> <br />Date of <br />Assessment <br />d <br />06/11/2007 <br />06/11/2007 <br /> <br />last D!lJ for <br />Reftlin, , <br />(e) <br />07/11/2017 <br />07/11/2017 <br /> <br />Un~ld lalane. <br />of Assessment <br />f) <br />17052.67 <br />391.80 <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 />17444.47 <br /> <br />This notice was prepared and signed at <br /> <br />CHI CAGO , IL <br /> <br />, on' this, <br /> <br />the <br /> <br />27th day of March <br /> <br />2009 <br /> <br />Signature <br /> <br />Title <br />ACS <br />for DEBRA K. HURST (800) 829-7650 <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. Rut. 71-466, 1971 .2 C.B. 409) Form 66Bro(e) (Rev. 2-2004) <br />Pan t . Kept By Recordlnr Offke CAT. NO 60025X <br /> <br /> <br />12-00-0000 <br /> <br />" <br /> <br />\V <br />