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05/20/2009 WSA 15:15 FAX 402 471 4429 UCC SECRETARY OF STATE ~yy Hall <br />~~ <br />8801 <br />bepartment of the Treasury -Internal Revenue Service <br />Form bb8 (Y)(t) <br />fRev. Feb-~~,„~004, Notice of Federal Tax Lien <br />.M:. , <br />Area: Serial Number Far Optional Use by Recordin pffice <br />SMALL BIISINESS/SELF EfdPLbYED A1tEA #4 <br />Lien Unit Phone: (800) 913-6050 54537.5409 "~ 5^~ o~ se,+~ <br /> <br /> <br />As provided by section b321, b3Z2, and b3Z3 of the Internal Revenue ~dti„ p <br />4ela _ pCC F7L <br />Code, we are giving a notice that taxes (Including interest and penalties) <br />have been assessed against the folbwing-named taxpayer. We have made <br />a demand far payment of this liability, put it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and ri hts to g90g5g7tae_T <br />property belonging to this taxpayer for the amount of these taxes <br />and ~~«a"~esr~~s~Z 0 <br />psi ~ t <br />, <br />additional penalties, interest, and costs that may accrue. e <br />at ~ sa pr, <br />Name of Taxpayer ROBERT MARTINET <br />Residence 301 E 2ND ST <br />GRAND T S LAND , NE 6 8 8 01- 7 711 ~ O ~ ~ O ~ ~ ~~ <br />IMPORTANT REl.FASE 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 fi325(a). <br />Tax Period Date of Last Dayy for <br />Kind of Tax >+nding Identifying Number Assessment Reflling Unpaid Balance <br />of Assessment <br />(a) (b) (c) d) (e) (~ <br />1040 12/31/2001 XXX-XX-$914 05/02/2005 06/01/2015 96$8.93 <br />7.040 1.2/31/2002 XXX-XX-$914 05/02/2005 06/01/2015 4750.82 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total ~$ 14439.75 <br />This notice was prepared and signed at <br />the 07th day of May <br />CHICAGO, IL <br />2009 <br />on this, <br />Signature ~ H '~,~~ Title <br />REVENUE OFFICER 24-10-1744 <br />for PATRICK J KELLOGG (308) 384-4850 <br />X007/008 <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. Rul. 71-466, 1971 - 2 C.B. 409) Form 6b8(lf)(c) (Rev. 2-2004) <br />Part 1 -Kept By Recording ice CAT. Np 60025X <br />