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<br />05/06/2009 WED 15:12 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />~o 0 81 0 0 9 <br /> <br />0'0 <br /> <br />8801 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notic~ of Federal Tax Lien <br /> <br />200903504 <br /> <br />Form 668 (Y)(c) <br />(Rav. February 20041 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />lien Unit Phone: (800) 913-6050 539354009 <br /> <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following~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 belonging to this taxpayer for the amount of these taxes, and <br />additional penaldes, interest, and costs that may accrue. <br /> <br />Name of Taxpayer FELIPE DELGADO SANTANA <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />9909595738-6 PsIs' 1 <br />SANTANA FEll PE DELGADO . <br />Filed: 05/06/2009 10,43 AM <br /> <br />Residence <br /> <br />504 W 6TH ST <br />GRAND ISLAND, NE 68801-4541 <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 IRe 6325(a). <br /> <br /> Tax Period Date of Last Da~ for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Reft ang of Assessment <br />(a) (b) (e) (d) (e) (f) <br />1040 12/31/2002 XXX-XX-3882 09/04/2006 10/04/2016 13417.56 <br />1040 12/31/2003 XXX-XX-3882 10/01/2007 10/31/2017 14916.99 <br />1040 12/31/2004 XXX-XX-3882 10/01/2007 10/31/2017 28296.89 <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 />56631.44 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />22nd day of April <br /> <br />2009 <br /> <br />Signature <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24-10-1737 <br /> <br />for MICHAEL W PONTE <br /> <br />(NOTE: Certificate of officer authorized by law to lake 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) IRev. 2-2004t\.~ t~ <br />Part I . Kept By Recording Office CAT. NO 60025X . ~:) <br />