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<br />04/21/2009 ~UE 14:33 FAX 402 471 4429 UCC SECRE~ARY OF S~A~E ~~~ Hall <br /> <br />14J002/003 <br /> <br /> <br />8801 <br /> <br />Form 668 (Y)(c) <br />(Flev. February 20041 f.."~~ <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Uen 2 ~;Q 9030 19 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 533624109 <br /> <br />As provided by section 6]21, 6]22, and 6]23 of the Internal Revenue <br />Code, we are giving a notice that taxes (includinr interest and penalties) , <br />have been assessed against the followins-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 belongln. to this taxpayer for the amount of these taxes, and <br />,additional penalties, interest, and costs that may acerue. <br /> <br />Name of Taxpayer ANTHONY T NOREM <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />Fn- <br /> <br />9909594212-1 Pes: 1 <br />NOREM ANTHONY T <br />Filed: 04/21/2009 11:10 AM <br /> <br />Residence <br /> <br />1823 W 3RD ST <br />GRAND ISLAND, NE 68803-5421 <br /> <br />IMPORTANT RlLEASE 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 63251a), <br /> <br /> Tax Period Date of Last Dr,r. for <br />Kind of Tax Ending Identifying Number Assessment Reft ng <br />(a) (b ' (c (d) e <br />1040 12/31/2001 XXX-XX-0502 04/15/2,002 05/15/2012 <br />1040 12/31/2001 XXX-XX-0502 03/24/2003 04/23/2013 <br />1040 12/31/2002 XXX-XX-OS02 04/05/2004 05/05/2014 <br />1040 1213.1/200,~ XXX-XX-0502 041.1.5/200~ 05/15/2016 <br />1040 12/31/2003 XXX-XX-0502 04/15/2004 05/15/2014 <br />1040 1~/31/2003 XXX-1OC-0502 08/16/2004 09/15/2014 <br /> <br />Unpaid Balance <br />of Assessment <br /> <br />3112.54 <br /> <br />4808.46 <br /> <br />727.30 <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 />8648.30 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, .IL <br /> <br />, on this, <br /> <br />Oath day of April <br /> <br />2009 <br /> <br />the <br /> <br />Signature <br /> <br />Title <br />ACS <br />for MICHAEL W. COX (800) 829-3903 <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. Ru!' 71-466. 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-20041 <br />~~-' w ,. .Part 1 - Kept By llecord1n, ORIce . "--. ....._ CAT. NO 6OP26X <br /> <br /> <br />24-00-0008 <br /> <br />"':,r.;-, <br />