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01/20/2010 WED 15:39 FA}[ 402 471 4429 UCC SECRETARY OF STATE y-~-~ Hall <br />Form 6d8 (Y)(c) <br />IRev. February 2004) <br />X004/007 <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number Far Options <br />BMALL BUSIN}SSS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-so5o 613961410 <br />As provided by section b321, 6322, and 633 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 vests that may accrue. <br />axpayer BRIAN <br />.TTEN <br />Residence 664 FAIDLEY PL APT 4 <br />GRAND ISLAND, NE 6$803-3436 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period Date of Last Dayy for <br />Kind of Tax Ending Identifying Number Assessment Refilling <br />a (b) (c) Cd) (e) <br />10,40 12/31/200$ XXX-XX-3755 11/02/2009 12/02/2019 <br />Inc. <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Usa by Recordin~t Office <br />NIL Ssc of 8k~la ~phn R 6~Ir - YCC F' <br />9930837355-4 P9a: f <br />PATTEN 9RIAN F <br />Filed: 01/20/2010 01.49 PM <br />Total ~$ 6329.74 <br />This notice was prepared and signed at <br />th® 07th day of January <br />Signature ~ A <br />for KAY PONTE <br />CHICAGO, IL <br />2010 <br />6329.74 <br />on this, <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br />201000442 <br />Unpaid Balance <br />of Assessment <br />24-10-1739 <br />~nu~c; l:ertitlcate of officer authorized by law [o take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 4091 Form 668(Y)(c) IRev, 2-2004) <br />Part 1 - Kept gy Recording Office <br />cA1r. No 6ooz6x <br />1 / ,~ <br />V <br />