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01/29/2010 FRI 14:55 FA% 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br />ia1004/004 <br /> 3592 <br /> Department of the Treasury -Internal Revenue Service <br />Formb68(Y)(c) 2Q1~DOSS3 <br />Lien <br />l T <br />f F <br />N <br />i <br />d <br />(Rev. February 20041 e <br />era <br />ax <br />ot <br />ce o <br /> <br />Area: <br />Serial Number Far nr,rinnal Use by Recording Office <br /> <br />SMALL BUSINEtiSS/$ELF EMPLOYED AREA #4 N^ S.~ ,r 5t.,. ~,,,~ p ~,~~ - ,~~ FTC <br />Lien Unit Phone: (soo) 913-605D 619477610 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that takes (including interest and penalties) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for pa ent of this liability, but it remains un aid. Therefore, <br />p ssi0stsa7a-a P9s: 1 <br />cOTTO FELIPE LOPEZ <br />there is a lien in favor of the united States an all property and rights to filed: 01/28/2010 10:45 qM <br />pr-operty belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer FELIPE LOPE,Z LOTTO <br />Residence 713 POPLAR ST <br />GRAND ISLAND, NE 68801-2755 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e1, this notice shall, <br />on the day following Such date, operate as a certificate of release as defined <br />. in IRC 6325(al. <br /> Tax Periiod Date of Last Dayy far Unpaid Baiapce <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />(a) (b) (c) d (e <br />1D40 12/37./2001 XXX-XX-4598 08/14/2006 09/13/2015 12474.81 <br />].040 12/31/2002 XXX-XX-459$ 08/14/2006 09/13/2016 5891.13 <br />1040 12/31./2004 XXX-XX-4598 08/03/2009 09/02/2019 8152.80 <br />1040 12/31/2005 XXX-XX-4598 08/03/2009 09/02/2019 5706.52 <br />1040 12/31/2005 XXX-~XX-4598 08/03/2009 09/02/2019 2779.97 <br />Place of Filing <br />Register of Deeds <br />Ha7.1 POBOX 1692 Total $ <br />Grand Island, NE 58802-1692 <br />This notice vvas prepared and signed at CHICAGO, IL <br />the 22nd day of January 2010 <br />- . --- -' <br />35005.23 <br />vn this, <br />Signature y~ A ~~ Title <br />,f REVENUE OFFICER 24-10--1744 <br />for PATRICK J KELLOGG (308) 384-4850 <br />(PIVI CS C.BrZITICBLe QT OttlCer BUinOrIZeU r]Y IdW [O iBKB aCKrlowlBaamen[ IS nUi aSSenudl lV uie vmiuny v~ IYy~lyp VI r cucim ~ ati uGn <br />Rev. Rul. 71-466, 1971 - 2 C.B. 408) Form 668(Y)(c) (Rev. 2-2004) <br />Part t -Kept By iecording Office CAT, NO 60025X <br />