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01/13/2010 9r'RD ].4:45 FAX 402 471 4429 UCC SECRETARY OF STATli ~~~ Ha11 <br />,(' }~C7 3 5 9 2 <br />V Department of the Treasury -Internal Revenue Service <br />Farm ddb (Y)(c) <br />(Rev. February 20041 Notice of Federal Tax Lien <br />. Area: Serial Number For optiona <br />SNI~,I,L BUSINESS/SELF' EM]?LOYED AREA #4 <br />Uae by Recording Office <br />urrn urnt r-none: (riUUJ ad9-3yo3 612604210 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue qE Sae of s~ala .re~+ w oa~• - ~« ~' <br />Code, we are giving a notice that taxes (including interest and penalties) , <br />have been assessed against the following-Hamad taxpayer. We have made <br />a demand for payment of this liability, but !t 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 991es166za-8 Pis ` ~ <br />additional penalties, interest, and costs that may accrue. ZIRKEL LESLIE SCOTT <br />Fllad: 01/13/2010 01:24 pM <br />Name of Taxpayer LESLIE SCOTT ZIRKEL <br />Residence <br />Kind of Tax <br />Ca) <br />1040 <br />1040 <br />1040 <br />Place of Filing <br />4015 KAY AVE <br />GRAND ISLAND, NE 68803-1506 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />the 01st day of January <br />Signature <br />for MICHAEL W. COX <br />ACS <br />(800) 829-3903 <br />178653.32 <br />24-00-0008 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tex lien <br />Rev. Rul. 71-4B6, 1971 - 2 C.B. 409) Form d68(Y)(c) (Rev. 2-2004) ~• <br />Part 1 -Kept By Retarding Office CAT. NO 60026X " <br />'~ J I <br />I <br />2010 <br />CHICAGO, IL <br />on this, <br />X005/005 <br />201000313 <br />Unpaid Balance <br />of Assessment <br />(f) __ <br />60083.47. <br />104622.83 <br />13947.08 <br />