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09/1$/2009 FRI 15:14 FAX 402 471 44z9 UCC SECRETARY OF STATE -+y~ Hall <br />Form 61i8 (Y)(c) <br />(Rev. February 2004) <br />Boaz/anz <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number Far Optional Use by Recording Office <br />SMALL HIISINFSS/SFsLF 13MPLOXTsD AREA #4 <br />Lien Unit Phone: (800) 829-3903 580898909 <br />AS provided by section b321, b322, and b323 of the Internal <br />Revenue Ne 5re of 5~•tv Jo1w R 6.1R - ~[G FYL <br />. <br />Cade, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the united States on all property and rights to <br />property belonging to this taxpayer far the amount of these taxes, and 9909607453-7 P95 = ~ <br />additional penalties, interest, and costs that may accrue. PEERS SCOTT <br />Filod: 09!18/2009 11:04 RM <br />Noma of Taxpayer SCOTT & DEBRA R PEPRS <br />Residence 527 MEVES AVE <br />GRAND ISLAND, NE 68801-7858 <br /> 200~U'7583 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />,unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 8325(a). <br /> Tax Period Date of Last Dayy far Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />a) b) c d e { <br />1040 12/31/2006 XXX-XX-3300 11/05/2007 12/05/2017 1.858.84 <br />1.040 12/31/2007 XXX-XX-3300 11/03/2008 12/03/2018 1843.31 <br />Piece of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total I$ 13702.15 <br />This notice was prepared and signed at <br />CHICAGO, IL <br />the 11th day of September, 2009 <br />on this, <br />Signature ~ y ~ <br />for MICHAEL W. COX <br />ACS <br />(800) 829-3903 <br />24-00-0008 <br />~._~.-- ..~.........••..•• •••••••••• .,,....,,.,moo., .,r, .o.., w .n..v a~.nn~w~auyn~Cna ie nun cs~csnum w tnv venu~ry ui wuueef vi rauerai lax nen <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 66$(n(c) (Rev. 2-20041~~' <br />Part 1 -Kept gY Recording Office CAT. NO 6pp25X <br />