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<br />04/10/2009 FRI 15:20 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />1dI0 0 5/ 0 0 6 <br /> <br />" <br /> <br />DO <br />Form 668 (Y)(C) <br />(Rev. FllbruafY 20041 <br /> <br />8801 <br /> <br />Department of the Treasury. Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />Area: <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829-7650 531807009 <br /> <br />A5 provided by section 6321, 6322, and 6323 of the Intemal Revenue <br />Code, we are alvin, a notice that taxes (including interest and penalties) <br />have been assessed against the foUowIng--named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefor_JI <br />there is a lien in favor of the United States on all property and risllts to <br />property belongin, to this taxpayer for the amount of these taxesJl and <br />addltiona~ penaltlesJl interest, and costs that may accrue. <br /> <br />Name of Taxpayer CLIFF R & ANNETTE R RICHARD <br /> <br />Serial Number <br /> <br />~ <br /> <br />1111l" r~m"l~ I <br /> <br /> <br /> <br />9909593049-3 Pgs. 1 <br />RICHARD CLIFF R . <br />F118~: 04/10/200901:55 PM <br /> <br />~- <br /> <br />200902695 <br /> <br />Residence <br /> <br />2323 BELLWOOD DR TRLR 107 <br />GRAND ISLAND, NE 68801-6205 <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 IRC 6325(a). <br /> <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br /> <br />Tax Period <br />Eriding <br />(b) <br />12/31/2006 <br />12/31/2007 <br /> <br />Identifying Number <br />tel <br />XXX-XX-7724 <br />XXX-XX-7724. <br /> <br />Date of <br />Assessment <br />(d) <br />06/04/2007 <br />05/19/2008 <br /> <br />Last Day-for <br />Refillng <br />(e) <br />07/04/2017 <br />06/18/2018 <br /> <br />-Unpaid Balance <br />of Assessment <br />(f) <br />3100.95 <br />2943.00 <br /> <br />,:.. <br /> <br />r: <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 />6043.95 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />02nd day of April <br /> <br />2009 <br /> <br />Signature <br /> <br />Title <br />ACS <br />for DEBRA K. HURST (800) 829-7650 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essentiel to the validity of Notice of Fedefal Tax lien \I ",' <br />Rev. Ru!. 71-466. 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004)'y <br />Part t . Kept By Recc>>rdln. OffIce CAT. NO 60025X <br /> <br /> <br />12-00-0000 <br /> <br />'- <br />