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D7/08/2009 [qED 15:05 FAX 402 471 4429 UCC SECRSTARX OF STATE ~yy Hall <br />• ~ 8801 <br />J <br />Department of the Treasury -internal Revenue Service <br />Pdrm bb8 (Y)(c) . <br />(flee. February 2004) Nonce of Federal Tax Lien <br />Area: _ Serial Number For Optional Use by Recordin Office <br />WAGE & 2NVE5TMElYT AREA #2 <br />Lien Unit Phane: (800) 829-7650 560425709 <br /> <br />As provided by section b321, b322, and b~23 of the internal Revenue NE See ei ilelo John A 6ela - Utt Fri <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 /> <br />property belonging to this taxpayer far the amount of these taxes, and 8808601476-~ Pas; 1 <br />5LECtrrA ANION E <br />additional penalties, interest, and casts that may accrue. Filed: 07/08/2009 08:46 AM <br />Name of Taxpayer ANION E SLECHTA <br />Residence p0 BOX 338 <br />DO <br />2UO9UCJCJ49 <br />NIPHAN, NE 6$832-0338 <br />iMi'ORTANT RELEASE iNEORMATION: For each assessment listed below, <br />unless notice of the lien is.refiled by the date given in column (e), this notice shall, <br />on the day fallowing such date, operate as a certificate of release as defined <br />in IRC 6325(8). <br /> Tax Period Date of Last Dayy far Unpaid Balance <br />Kind of Tax Ending identifying Number Assessment Refiling of Assessment <br />(a) b) c ~ d (e) f <br />1040 12/31/2003 XXX-XX--3150 02/25/2008 03/27/2018 5314.88 <br />1040 1Z/31/2004 XXX-XX-3150 02/25/2008 03/27/2018 19266.66 <br />1040 12/31./2005 XXX-XX-3150 10/27/2008 11/26/2018 ].1508.48 <br />Place of Filing <br />Register of Deeds • <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total I$ 36090.02 <br />This notice was prepared and signed at <br />the 25th day of June 2009 <br />~DD3/DDS <br />on this, <br />Signature ~ ~ \r~ ACS 12-00-0000 <br />for DEBRA K. HURST (800) 829--7650 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal 1"ax lien <br />Rev. RuI. 71-466, 1971 - 2 C.B. 409) <br />Part 1 -Kept By Recording Office Form 6b8(ln(t) (Rev. 2-2004) <br />- - CAT. NO 60025X <br />~.L .. .. ......, • ~. ..• <br />CHICAGO, IL. <br />