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<br />04/15/2009 WED 12:25
<br />
<br />'Dlb
<br />
<br />Form 668 (Y)(c:)
<br />
<br />PAX 402 471 4429 UCC SBCRBTARY OF STATB ~~~ Hall
<br />
<br />21009/009
<br />
<br />8801
<br />
<br />"" IRev. February 20041
<br />
<br />Department of the Treasury - Internal Revenue Service _
<br />Notice of Federal TalcLien
<br />
<br />200902829
<br />
<br />Area: Serial Number
<br />SMALL BUSINESS/SELF EMPLOYED AREA #4
<br />Lien Unit Phone: (800) 913-6050 532659409
<br />
<br />Id provided by section 632t, 6322, and 6323 of die Internal Revenue
<br />Code, we .... ,livin, a notice that taxes (includin, interest and penalties)
<br />have been assessed aplnst the followlnr-named taxpayer. W. have made
<br />a demand for payment of this UabUlty, but It remains unpaid. Therefore,
<br />there is a lien In faVor of the United States on all property and rights to
<br />property belonain, to this taxpayer for the amount of these taxes, and
<br />additional penaleles, Interest, and costs that may accrue.
<br />
<br />Name of Taxpayer MICHAEL CORDOVA
<br />
<br />For 0 tlonal Use by Recording Office
<br />
<br />
<br />9909593578-4 Pgs: 1
<br />CORDOVA MICHAEL.
<br />Filed: 04/15/2009 11:09 AM
<br />
<br />Residence
<br />
<br />322 W 8TH ST
<br />GRAND ISLAND, NE 68801-4224
<br />
<br />- _ ItI'9~MfT;;~,"~~:I~FOIUQTlON: For each assessment liste~ below,
<br />"unl~S8,f1~lp' ,WJh,e:,h~n..:!~>J,fdE!~.,~Y,.~h~: ~~te gl_ven In ~olumn (e), this notice shaJI,
<br />'0- - - on the dBY folloWiOO- s~lt"idate; operate as, 8 certificate of release as defined
<br />in IRe '6326(8);' ~"-' -- -
<br />
<br />';;1-.. .
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<br />
<br />? .',. :'.~ .,;", ."
<br />. .,... ~ . .
<br />
<br />Date of
<br />Assessment -
<br />(d)
<br />09/04/2006
<br />04/09/2007
<br />07/17/2006
<br />
<br />. ad;:Di' for
<br />,ae~~H "~Co',:
<br />e) ',..,., ,
<br />10/04/2016
<br />05/09/2017
<br />08!-16/2016
<br />
<br />UtpldBaiance
<br />. of Assessmen~
<br />
<br />Tax Period
<br />Kind of Tax ;' Endin, .
<br />a) b
<br />. . i04'O,_: ,: 12/31/2(Hro
<br />. i04'Q_', ,_12/3-],t20:(>1
<br />'. ..-~,:,~~'?:2',,;r: ,;~~r~:~r~i:R;q:~;
<br />
<br />,Identifyin, Number
<br />c)
<br />XXX-XX-'3109
<br />-~XXX-XX-3109"
<br />, XXX...XX:'3109
<br />
<br />
<br />3934.91
<br />8887.02
<br />10935.69
<br />
<br />
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<br />
<br />.'. . ~. "'., ~,. '.< ;.. "
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<br />
<br />'. .~:.;.': ".;': :;~':i .~:j, :",~':.:1:'~ (. .~:;, .~~:;~? j : :.:~:".. ~"., :' '.
<br />
<br />: Place of Fj!~rg .-
<br />
<br />"R~gister' of Deeds
<br />Hall POBOX 1-692
<br />" Grand Island, NE 68802-1692
<br />
<br />Total" $.
<br />
<br />23757.62 n',
<br />
<br />~. ''''''~'
<br />
<br />This' notice was,pr,e~8red' ~rid' signed at
<br />
<br />CHICAGO, IL
<br />
<br />.. ::.
<br />
<br />, on this,
<br />
<br />the
<br />
<br />"M
<br />
<br />06th day of April
<br />
<br />.."
<br />
<br />: .,~.
<br />.. ""~'
<br />
<br />~ .. .
<br />
<br />2009
<br />
<br />. _Signature
<br />
<br />Title
<br />REVENUE OFFICER
<br />. for WILMA K ,PONTE (308) 384-4850'
<br />
<br />(NOTE:Certiticate of officer authorized by law to take ecknowledgment is not essential to the validity,of,~~tice of Federal Tax lien ~C\
<br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) . , Form 668(Y)(c) (Rev, 2-20 ) ~.J
<br />'. Pare. . Kept By Record.. OftIce " CAT. NO 60025)(\....
<br />
<br />
<br />24-10-1739
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