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12/28/2009 MON 14:44 FAX 402 471 4429 UCC SECRETARY OF STATE aa~ Ha17. <br />359 <br />Form 668 (Y)(c) <br />(Rav. February 2004) <br />N-rea: Serial Number <br />wA~> & zrrvgs~z~T A1~A #z <br />Lien Unit Phone: (800) 829-7650 608234109 <br />As provided by section 6321, 6322, 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 fallowing-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, atld casts that may accrue. <br />Name of Taxpayer HIRAM MAA]UEL FIGIIEROA <br />Residence 412E 6TH ST <br />GRAND ISLAND, NE 68801-4307 <br />CHICAGO, TL <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 D for <br />Kind a# Tax Ending Identifying Number Assessment Refi~ng <br />(a) b (c d e <br />1040 12/31/2003 XXX-XX-4446 03/1G/2009 D4/15/2019 <br />1040 12/31/20D6 XXX-XX-0446 03/16/2009 04/15/2019 <br />Place of filing <br />Ia1005/007 <br />Register of Deeds <br />Ha11 POBOX 1692 <br />Grand Island, NE 6$$02-1692 <br />5535.55 <br />5442.63 <br />Total ~$ 10978.18 <br />This notice was prepared and signed at <br />200910145 <br />Unpaid Balanite <br />of Assessment <br />the 16th day of December 2009 <br />Signature <br />on this, <br />for SUSAN MEREDITH <br />Title <br />ACS <br />(SDO) 829-7650 <br />14-00-0000 <br />(ROTE: Certificate of officer authorized 6y law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) <br />Part 1 -Kept sy Recording Office Form 668(Y)(t) (Rev. 2-2004) <br />CAT. NO 60025X <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />For t]ptional Use by Recording Office <br />NE Sre of 51~as John R Oalr - B[G NTH' <br />gg09g16292-5 pss: 1 <br />FIGUEROA HIRAM MRNUEI. <br />Fllad: 12!28!2009 11:63 pM <br /> <br />