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02/02/2010 TUE 16:00 FAX 402 471 4429 UCC SECRETARY OF STATE ...... Hdll <br />3592 <br />0 ~ Department of the Treasury -Internal Revenue Service <br />Form 66$ (Y)(r) <br />(Rev. February 20041 Notice of Federal Tax Lien <br />Area: Serial Number <br />SMALI, BUSINL:$S/SELF EMPLOY)±;A AREA #4 <br />Lien Unit Phone: (8'00) 913-6050 619880510 <br />As provided by section 6321, 6322, and b323 of the internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />property belonging to this taxpayer far the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer MOHAMED T HAMTD <br />Residence 213 S CEDAR STREET <br />GRAND ISLAND , .. NE 6 8 8 01 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />For <br />201000750 <br />Use by Recording Office <br />Ni fog of ftsl~ JoFp a Ede -UCC FTL <br />9910818647-4 Pgs: t <br />HAMID MOHAMED T <br />Filed: 02!02/2010 11:07 AM <br />Tax Perlad Date of Last Dayy For ' <br />Kind a) Tax En bij g identifying Number Auessment Refiling <br />104o 12/31/2008 xxx-Xx-1892 11/16/2009 12/~~/2019 <br />Place of Filing <br />6570.81 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total ~$ 6570.81 <br />This notice was prepared and signed at CHICAGO, TL <br />the 25th day of .January 2010 <br />Signature <br />for SITSAN <br />on this, <br />ITH <br />Title <br />ACS <br />(800) 829-7650 <br />lJnpaid Balance <br />of Assessment <br />15-00-0000 <br />(rr(TfE: 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, 1571 - 2 C.B. 409) <br />Part 1 -Kept ey Recording Office Form 668(Y)(t) IRev. 2-2004) <br />CAT. NO 60025X <br />iai004/004 <br />