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10/29/2009 THC) 14:31 FAX 402 471 4429 UCC SECRETARY 08 STATi, ~~~ Hall <br />36$ <br />200908647 <br />Form 668 (Y)(t) <br />(Rev. February 2004) Notice of Federal Tau Lien <br />Area: Serial Number For Options <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 591570509 <br />As provided by section 6321, 4322, 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 DIANE K LEETCH <br />AKA DIANE SPAULDING <br />Residence 2111 W 10TH ST <br />GRAND ISLAND, NE 68803-3611 <br />IMPORTANT RELBAS~ 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 IfiC 6325(a). <br />Tax Period Date of Last Daayy for <br />Kind of Tax finding Identifying Number Assessment ~eRiling <br />1.040 12/31/2002 XXX-XX-0043 05/26/2003 06/25/2013 <br />1040 12/31/2003 XXX-XX-0043 OS/31/2004 06/30/2014 <br />Place of Filing <br />Register of Deeds <br />Ha11 POBOX 1692 <br />Grand Ts].and, NE 6$$02-1692 <br />Use by Recordir-n Office <br />NE 5re a~ Skrka Jah,1 R Gslr - IICC F1L <br />99086'10755-2 Pas ~ 1 <br />LEETCH DIANE K <br />Filed: 10!2912009 10:06 AM <br />X004/004 <br />4021.04 <br />776.39 <br />Total ~$ 4797.43 <br />This notice was prepared and signed at <br />the 20th day of _ October <br />Signature ~ f7 ~ <br />for MICHAEL W. COX <br />Department of the Treasury -Internal Revenue Service <br />ACS <br />(800) 829-3903 <br />Unpaid Balance <br />of Assessment <br />24-00-0008 <br />CHICAGO, IL <br />2009 <br />on this, <br />(NOTE: Cer6fieate of officer authorized by law to take acknowledgment is net essential to the validity of Notice of Federal Tex lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) <br />Part 1 - Kit sY R~etordiaa office Form 668(n(e) IRev. 2-2004) A./ <br />CAT. NO 60025X <br />