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12/28/2009 MQN 14:45 FAR 402 471 4429 ^CC SECRETARX OF STATE ~~~ Hdll <br />0006/007 <br />3592 - <br />Department of the Treasury -Internal Revenue Service <br />iF°r~ 6ba (Y)(`) Nonce of Federal Tax Lien <br />(Rev. February 2004) , <br />Area: Serial Number For Q tional Use by Racordin Office <br />SMALL BUSINESS/SELF EMPLOXED AREA #4 <br />h" ~ °~`~ - ucc ~T~' <br />' <br />Lien Unit Phone: (800) 829-3903 608880209 ° <br />Ne ~°~ °' *'°'" ' <br />As provided by section 4321, b322, and 4323 aF the Internal Revenue <br />Cade, 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, t <br />there is a lien in favor of the united States an all property and rights to Qgs, <br />g9m9et52s3~~ <br />G <br />9A <br />~ <br />property belonging to this taxpayer far the amount Of these taxes, and 2 <br />~l2008 11 :53 An <br />lad= <br />Fi <br />additional penalties, interest, and- casts that may accrue. <br />Name of Taxpayer TODD & CHERYL SWARTZBAUGH 2 ~ 0 91 ~ 1 4 <br />Residence 3448 SCI3ROEDER AVE <br />GRAND ISLAND, NE 68803-6529 <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 fi325(a). <br /> Tax Period ~ Date of hart Dayy for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />a b) (c) d (e) (fl <br />1040 12/31%2006 XXX-XX-2399 09/29/2008 10/29/201$ 1310.18 <br />1040 12/31/2007 XXX-XX~2399 06/01/2009 07/01/2019 16625.40 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ 17935.58 <br />Grand Island,. NE 58802-1692 <br />This notice was prepared and signed at CHYCAGO, IL <br />the - 17th day of December 2009 <br />on this, <br />Signature ~ y ~~~,,~ ACS 24-00-0008 <br />for MrCHAEL W. COX (800) 829-3903 <br />(NOTE; Certificate of officer authorized by law to take acknowledgment is net essential to the validity of Notice of Federal Tax lien <br />Rev, Rul. 71-466, 1971 - 2 C.B. 409) Farm 668(Y)(c) (Rev. 2-2p041 <br />Part 1 -Kept B~- Recording Office CAT. NO 60025X <br />