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12/lQ/2009 THU 8:12 FAX 402 471 4429 UCC SECRETARY OF STATE yyy Hall X006/007 <br />3592 <br />Department of the Treasury -Internal Revenue Service <br />Form 668 (Y)(t) 2 O O 9 O~~~ g <br />(Rev. February 2004) Notice of Federal Tax Lien <br />Area• Serial Number For 4gtional Use by Recording office <br />SMALL BIISI]YESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 601507909 <br /> <br /> <br />As prQVlded by section b321, 6322, and 6323 of the lnternal Revenue NE S9C pF S!r\o John R Gele - VCC F7L <br />Gode, 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 far payment ~af this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States an all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and pSjACeicu6 noR s3-7 Pss: 1 <br />additional penalties, interest, and Lost: that may accrue. F11ed; 12!08/2009 02:18 PM <br />Name of Taxpayer DORIS MACKI;I <br />Residence 106 E FRONT ST <br />ALDO, NE 6$$10-9733 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e1, this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325faf. <br /> Tax Period Date of Last Dar~rr for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />(a) (b) c (d) (e) (f) <br />940 12/31/2003 47-0824016 10/12/2009 11/11/2019 353.09 <br />940 12/31/2005 47-0$24016 0$/03/2009 09/02/2019 <br />940 12/31/2005 47-08.24016 09/21/2009 10/21/2019 63.55 <br />940 12/31/2006 47-0824016 OS/b4/2009 06/03/2019 163.09 <br />940 12/31/2007 47-0824016 05/04/2009 06/03/2019 157.66 <br />941 06/30/2007 47-0824016 04/13/2009 05/13/2019 1271.67 <br />941 09/30/2007 47--0824016 04/13/2009 05/13/2019 1407.72 <br />941 12/31/2007 47-0$24016 04/13/2009 05/13/2019 1394.51 <br />941 03/31/20p8 47-0824016 06/15/2009 07/15/2019 1403.51 <br />Place of Filing <br />Register of Deeds <br />Hall POBQX 1692 <br />Grand Island, NE 6$802-1692 <br />Total ~ $ 6 214 .8 0 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the 24th day of November 2009 <br />Signature ~ Title <br />REVENUE OFFICER 24-14-1720 <br />for DANIELLE L MUELLER (402) 473-4675 x2912 <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. Rul. 71-466, 1971 - 2 C.9. 409) Form b68(Y)(c) (Rev. 2-20041 <br />Part 1 • Kept By Recording Office CAT. NO 60025X <br />