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<br />05/15/2009 FRI 14:33 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />iii 0 0 5/ 0 0 6 <br /> <br />y <br /> <br />Form 668 (Y)(c) <br />~ -.{Rev. February 2004) <br /> <br />8801 <br /> <br />Department of the Treasury - Internal Revenue Service <br /> <br />Notice of Federal Tax Lien <br /> <br />Area: Serial Number <br />WAGE & INVESTMENT AREA #2 <br />Lien Unit Phone: (800) 829-7650 543893509 <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 penalties, interest, and costs that may accrue. <br /> <br />Name of Taxpayer JON J BREDVICK <br /> <br />For 0 tional Use by Recording Office <br />utt I'TL <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />~::~~C~i~Ji009 09:39 Al'1 <br />FL l_d: <br /> <br /> <br />Residence <br /> <br />2445 LAMAR AVE <br />GRAND ISLAND, NE 68803-6233 <br /> <br />20090378.3 <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 />: ! <br /> <br />.. ) <br /> <br />Kind of Tax <br />(a) <br />1040 <br />1040 <br /> <br />Tax Period <br />Ending <br />b) <br />12/31/2006 <br />12/31/2006 <br /> <br />Identifying Number <br />(c <br />XXX-XX-0925 <br />XXX-XX-0925 <br /> <br />Date of <br />Assessment <br />(d) <br />04/15/2007 <br />07/07/2008 <br /> <br />Last Day for <br />Refillng <br />(e) <br />05/15/2017 <br />08/06/2018 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br /> <br />6877.54 <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 />6877.54 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />OSth day of May <br /> <br />2009 <br /> <br />Signature <br /> <br /> <br />Title <br />ACS <br />(800) 829 -7650 <br /> <br />12-00-0000 <br /> <br />for DEBRA K. HURST <br /> <br />(NOTE: Certificate of officer authorized bv law to lake acknowledgment is not essential 10 the validity of Notice of Federal Tax lien <br />Rev. Rul. 71.466, 1971 . 2 C.B. 409) <br /> <br />Parc 1 . Kept By Recording OffIce <br /> <br />Form 668(Y)(c) (Rev. 2-2004) <br />CAT. NO 60025X <br /> <br />\.: <br />