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d <br />02/25/2005 17:06 FAX 14024714429 NEBRASKA UCC <br />200501629 <br />Q 003/005 <br />This notice was prepared and signed at <br />the 14th day of February <br />2005 <br />ST PAUL, MN <br />on this, / ) <br />Signature Title <br />ACS 15 -00 -0000 <br />for WANDA W. BROWN (800) 829 -7650. <br />(DOTE: 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 668(Y)(c) (Rev. 2 -20041 <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />9303 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 (Y)4) <br />Notice of Federal Tax Lien <br />(Rev. February 2004) <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (65 1) 312 - 60 B 0 <br />214214105 <br />164•4• - U" <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 aI( property and rights to <br />Pss° 1 <br />property belonging to this taxpayer for the amount of these taxes, and <br />FFi1� 02125 2005 02:56 PM <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer MARCELO SALAZAR <br />Residence 210 N PIPER APT 2 <br />GRAND ISLAND, NE 68803 <br />NT RELEASE INFORMATION: For each assessment listed below, <br />of the lien is refiled by the date given in column (e ), this notice shall, <br />EIRC <br />following such date, operate as a certificate of release as defined <br />(a). <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refilling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(� <br />1040 <br />12/31/2002 <br />556 -35 -8555 <br />04/15/2003 <br />05/15/2013 <br />1040 <br />12/31/2002 <br />556 -35 -8555 <br />10/25/2004 <br />11/24/2014 <br />8799.17 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 8799.17 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 14th day of February <br />2005 <br />ST PAUL, MN <br />on this, / ) <br />Signature Title <br />ACS 15 -00 -0000 <br />for WANDA W. BROWN (800) 829 -7650. <br />(DOTE: 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 668(Y)(c) (Rev. 2 -20041 <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />