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02/25/2005 17:07 FAX 14024714429 NEBRASKA UCC <br />IA 004/005 <br />200501630 <br />This notice was prepared and signed at ST PAUL, MN on this, <br />the 14th day of February 2005G'� <br />Signature Title <br />ACS 29 -00 -0008 <br />for S KILPATRICK (800) 829 -3903 <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. Ru[, 71 -466, 1971 - 2 C.B. 4091 <br />Part 1 - Kept By Recording Office Form 668( CAT (Rev. 025X ) <br />CAT. nio soo2sx <br />9303 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 (Y)(c) <br />Notice of Federal Tax Lien <br />(Rev. February 20041 <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (651) 312 -8080 <br />214218505 <br />RE 96c -s 9464. - ucc FM <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 (lability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on aff property and rights to <br />9906331176 -8 pas: f <br />property belonging to this taxpayer for the amount of these taxes, and <br />MILLER DANNY G <br />additional penalties, interest, and costs that may accrue. <br />Filed: 02/25/2005 02:56 PM <br />Name of Taxpayer DANNY G MILLER <br />Residence 2416 N TAYLOR AVE <br />GRAND ISLAND, NE 68803 -2035 <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 IRC 6325(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 />Refiring <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2000 <br />505 -76 -9575 <br />03/22/2004 <br />04/21/2014 <br />5324.75 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 5324.75 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at ST PAUL, MN on this, <br />the 14th day of February 2005G'� <br />Signature Title <br />ACS 29 -00 -0008 <br />for S KILPATRICK (800) 829 -3903 <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. Ru[, 71 -466, 1971 - 2 C.B. 4091 <br />Part 1 - Kept By Recording Office Form 668( CAT (Rev. 025X ) <br />CAT. nio soo2sx <br />