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01/22/2010 FRI 14:24 E'AX 402 471 4429 UCC SECRETARY pF $TATL y~~ Hall I~I004/004 <br />3592 201000499 <br />Department of the Treasury -Internal Revenue Service <br />Form 668 (Y)(c) <br />(Rev. February 2004) Notice of Federal Tax Lien <br />Area• Serial Number F~ " --~---~ , ~^_ -.., Rarnrdiga QfflC6 <br />SMALL BUSINESS/SELT~' EMPLOYED AREA #4 "~ a.~e er st,a John a au.. <br />uce Fri <br />Lien Unit Phone: (800) 913-6050 616065110 <br />As provided by section 6321, 6322, and 6323 of 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, ~>;eaa7s~-2 pgs: 1 <br />Nara Buis a <br />there is a lien in favor of the llnlted States on all property and rights to Filed: 0~izz,zete 1eae an <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and vests that may accrue. , <br />fVame of Taxpayer LUIS A NATAL <br />Residence PO BOX 1442 <br />GRAND ISLAND, NE 68802-1442 <br />IMPORTANT REl.gASE INI`ORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column {e), this notice shall, <br />an the day following such date, operate as a certificate of release as defined <br />in IRC 8325(a). <br /> <br />Kind of Tax Tax Period <br />Ending <br />ldentifj-tng Number Date of <br />Assessment last Dayy far <br />Refiling Unpaid Balance . <br />of Assessment <br />(a)' (b (c) (d (e) ~ f) <br />1,040 12/31/2007 XXX-XX-8171 03/31/20D8 04/30/2018 <br />1D4Q 12/31/2007 XXK-XX-8171 11/09/2D09 12/09/2019 12344.38 <br />Place of Filing <br />Register of Deeds <br />Ha11 POBOX 1692 Tatal $ 12344.38 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />the 13th day of January <br /> <br />Signature A Title ;, <br />REVENUE OFFICER 24-10-1737 <br />for MICHAEL W PONTE (308) 384-4850 <br />CHICAGO, IL <br />201,0 <br />on this, <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. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-2004) V <br />Part t -Kept sy Recording Office CA7. NO 80025X <br />