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<br />04/30/2009 THU 14:39 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121003/003 <br /> <br />co:;' <br />Form 668 (Y)(C) <br />(Rev. February 2004) <br /> <br />8801 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />, <br />...,.".. <br /> <br /> <br />FTL <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 538658809 <br /> <br />As provided by section 632t, 6322, and 6323 of che Inlemal Revenue <br />Code, we are giving a nodee that taxes (includinglneerest and penalties) <br />have been assessed apinst the followinl"named taxpayer. We have made <br />a demand for paymene Or this Dability, bue ie remains unpaid. Therefore, <br />ehere is a lien in favor of ehe Unked Scaees on all property and rlghes eo <br />property belongine CO ehis taxpayer for ehe amounC of chese caxes, and <br />addldonal penalties,- Ineerese, and costs chae may acclVe. <br /> <br />Name of Taxpayer GARY J WARTA <br /> <br />9909595125-7 PSS' , <br />WARTA GARY J <br />Filed: 04/~/2009 10:39 A" <br /> <br />Residence <br /> <br />2907 W 17TH ST <br />GRAND ISLAND, NE 68803-2408 <br /> <br />200903270 <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 /> <br />Tax Period <br />Ending <br />b <br />12/31/2004 <br /> <br />Identifying Number <br />c <br />XXX-XX-7916 <br /> <br />Date of <br />Assessment <br />(d) <br />03/24/2008 <br /> <br />Last Day for <br />Refiline <br />(e) <br />04/23/2018 <br /> <br />Unpaid Balance <br />of Asse.ssmenc <br />(f) <br />20438.54 <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 />20438.54 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />r on this, <br /> <br />the <br /> <br />21st day of April <br /> <br />2009 <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829-3903 <br /> <br />24-00-0008 <br /> <br />for MICHAEL W. COX <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity ot Notice of Federal Tax lien <br />Rev. Ru!' 71-466,1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-20041. _ <br />Pan t - Kept By Recording OffIce CAT. NO 60025X V <br />