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12/10/2009 THU 8:12 FAR 402 471 4429 UCC SECRETARY OF STATE ~yy Hall <br />Farm 668 (Y)(t) <br />(Rev. February 2004) <br />ia1005/007 <br />592 <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area:• Serial Number For Optional Use by Recording Office <br />SMALL B17SIN>aS5/SELF' EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-f>a50 601507809 <br /> <br />AS provided by section 6321, b3~2, and d3~3 of the Internal Revenue NE Sea ai Skak- John A Bole - l![C FTL <br />Code, we are giving a notice that takes (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 Starts on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and r9iac0icu6noRis~_5 ~'~` 1 <br />additional penalties, interest, and costs that may accrue. Filed: rxrmerzoas az:,z ~M <br />Name of Taxpayer DORIS MACKU <br /> 2oo9o9s7~1 <br />Residence 106 E FRONT ST <br />ALDO, NE 6$81D-9733 <br />IMPORTANT REi.EASE INFORMATION: Far each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such data, operate as a certificate of release as defined <br />in IBC 6325(al. <br /> Tax Period Date of Last Dayy far Unpaid Balance <br />Kind of Tax Ending identifying Number Assessment Refiling of Assessment <br />a (b c) (d (e) (f) <br />941 06/30/2002 47-0824016 08/31/2009 09/30/2019 2171.97 <br />941 09/30/2002 47-0824016 08/31/2009 09/30/20].9 2789.44 <br />941 12/31/2002 47-0824016 08/31/2009 09/30/2019- 2570.94 <br />941 03/31/2003 47-0824016 10/05/2009 11/04/2019 2854.0$ <br />941 06/30/2003 47-0824016 09/28/2009 10/28/2019 2522.86 <br />941 09/30/2003 47-0$24016 09/28/2009 10/28/2019 2729.03 <br />941 12/31/2003 47-0824016 09/28/2009 10/28/2019 1216.89 <br />941 03/31/2005 47-0824016 05/25/2009 06/24/2019 1039.29 <br />941 06/30/2005 47-0824016 05/25/2009 06/24/2019 1479.40 <br />941 09/30/2005 47-0$24016 05/25/2009 06/24/2019 1481.17 <br />941 12/31/2005 47-0824016 05/2x/2009 06/24/2019 1479.55 <br />X41 03/31/2006 47-0824016 05/04/2009 06/03/2019 588.48 <br />941 06/30/2006 47-0$240].6 05/04/2009 06/03/2019 563.61 <br />941 09/30/2006 47-0824016 05/04/2009 06/03/2019 535.35 <br />941 12/31/2006 47-0824016 05/04/2009 06/03/2019 505.90 <br />Place of Filing <br />Register o~ Deeds <br />Ha11 POBOX 1692 Total $ 24527.96 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHICAGO, IL ~ , an this, <br />the 24th day of November 2009 <br />Signature A ~ REVENUE OFFICER 24-10--1720 <br />for DANIELLE L MUELLER (402) 473-4675 x2912 <br />(NOTE: Certificate of officer authorized by Isw to take acknowledgment is not essential to the vallpity of Notice of reaerai i ax uen <br />Rev. Rul. 71-466, 1971 - 2 C.L3. 409) Form 668(Y)(c) iRev, 2.2004) <br />Part 1 -Kept BY RecordinE ~ce CAT. NO fi0025X <br />