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(0}2/22/2010 MpN 15:17 FAX 402 471 4429 UCC SECRETARY pF STATE ~yy Hall <br />~ }(J 3477 <br />\J _ Department of the Treasury Internal Revenue Service . <br />Form 668 (Y)(c) <br />(Rev. February 2004) Notice Of Federal Tax lien 2 410 0117 5 <br />Area; Serial Number For Optional Use by Recording Office <br />SMALL BUSINESS/SEL,F EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 97.3-6050 624783810 <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 for the amount of these taxes, and <br />additional penalties, interest, and casts that may accrue. <br />Name of Taxpayer DORIS MACKU <br />Residence 106 E FRONT HWY 3 0 <br />ALDA, NE 6 8 810 <br />IMPORTANT R<~I,EASE INFORMATION: For each assessment listed below, <br />.unless notice of the lien is refilad by the date given in column (e), this Halite 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 Las>>i Dady for <br />Kind of Tax Ending Identifying Number Assessment ReBlin <br />(a) (b) (c) d e) g <br />941 06/30/2008 47-0824016 12/2$/2009 01/27/2020 <br />941 09/30/200$ 47-0824015 7.2/2$/2009 01/27/2020 <br />941 12/31/2008 47-0824016 12/28/2009 01/27/2020 <br />941 06/30/2009 47-082407.6 12/2$/2009 01/27/2020 <br />Place of Filing <br />Register of Deeds <br />Hall POEOX 1692 <br />Grand Island, NE 68802-1692 <br />Unpaid Balance <br />of Assessment <br />f~1002/003 <br />1079.83 <br />23$7.62 <br />1477.94 <br />1614.45 <br />Total ~$ 6559.84 <br />This notice was prepared and signed at CHICAGO, IL <br />the 10th day of February 207.0 <br />Signature ~ ~ ! i'~Gt <br />for DANIELLE L MUELLER <br />Title <br />REVENUE OFFICER 24-10-1720 <br />(402) 473-4675 x291.2 <br />(NO'rIK: Certificate of officer authorized by law tv take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 4p9) <br />Part t • Kept i3y Recording Office Form i568(Y)(c) )Rev. 2-2004) <br />car. Iva sao,~5x <br />iioRYS -` Nes: t <br />02/22l2W10 10:86 AM <br />an this, <br />