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03/04/2005 16:29 FAX 14024714429 NEBRASKA UCC <br />200501951 <br />U" 1872 <br />Department of the Treasury - internal Revenue Service <br />Z003/005 <br />Form 668 M(c) Notice of Federal Tax Lien <br />(Rev. February 2004) <br />Serial Number For Optional Use by Recording Office <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 215241905 <br />Lien Unit Phone: (800) 629 -3903 <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 />Name of Taxpayer JIM K KEESHAN <br />Poo: 1 <br />Residence 110 W 2ND ST <br />GRAND ISLAND, NE 68801 -5906 <br />=6325(a). LEASE INFORMATION: For each assessment listed below, <br />lien is refiled by the date given in column (e), this notice shall, <br />ing such date, operate as a certificate of release as defined . <br />Tax Period Date of Last Day for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />(a) (b) (c) (d) (e) (f <br />1040 12/31/2002 505 -84 -1420 03/29/2004 04/28/2014 9266.58 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at ST PAUL, MN <br />the 22nd day of February 2005 <br />Signature <br />ACS <br />9266.58 <br />on this, <br />�C <br />29 -00 -0008 <br />kMWAD; kU1L111UVLV U1 U111­1 <br />Rev. Rul. 71-466,197, - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -2004) <br />n..+ f _ ire Rv V?x dinw Office f`nT run ann ?Fy <br />I <br />