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12/15/2009 TUE 14:41 FAX 402 471 4429 UCC SECRETARY OF STATE ~yy Hdll <br />•~ 359 <br />D~ .Farm b68 (Y)(c) <br />IRev_ February 2004) <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number For Options <br />SMALL BUSYNESS/SELF EMPLC+XED AREA, #4 <br />••° Lien Unit Phone: (800) 913-6050 509:557109 <br />.• As provided by section b321, 632x, and 63,23 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 IRVING J OTERD VAZOUEZ <br />Residence 5pg N VINE $T <br />F:~ GRAND ISLAND, NE 58801-4348 <br />IMPORTANT R>r14EAS~ INFORMATION: For each assessment listed below, <br />'~ unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in .IRC 6325(a). <br />NE Ssc Of Stgq Bohn q Gds - IICC FTL <br />9909614265-7 Pgs: 1 <br />OTERO VAZpUEZ IRVING J <br />Filed: 12/1612009 11:01 AM <br />200909839 <br />lJnpaid Balance <br />of Assessment <br />i~1003/007 <br />Tax Period Date of Last Dayy for <br />Kind of Tax Ending Identifying Number Assessment ReB[ing <br />(a (b) (c) (d) (e) <br />10~o i2/31/2ao1 XXX-XX-5561 11/07/2005 12/07/2016 <br />1040 1.2/3J./2002 xXX-XX-5551 1./07/2005 1.2/07/2015 <br /> <br />Plape of Filing <br />. Registrar of Deeds <br />" Hall POSOX 1692 <br />. Grand Island, NE 68802-1592 <br />5o32.s7 <br />3830.73 <br />Total ~$ 9863.60 <br />'This notice was prepared and signed at CHICAGO, IL <br />the 04t:h day of December 2009 <br />Signature <br />for DANI <br />on this, <br />L MUELLER <br />Title <br />R$VENUE OFFICER 24-10--1720 <br />(402) 473-4675 x2912 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is npt essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-46fi, 1971 - 2 C,6, 409) <br />Part 1 -Kept >sy Recording Office Form 668(Y)(c) (Rev. 2-2004) <br />CAT. NO 60p25X <br />Use by Recording Office <br />