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04/22/2010 THU 14:39 FAX 402 471 4429 UCC SECRETARX OF STATE ~~~ Hall ~ 3592 pepartment of the Treasury -Internal Revenue Service Form 668 (Y)(c) (Rev. February 2004) Notice of Federal Tax Lien 2 410 0 2 6 8 5 Area: Serial Number For Optional Use by Recording Office SMALL BUSINESS/SELF EMPLgYED AREA #4 Lien Unit Phone: (800) 829-3903 64397011D As provided by section 6321, 6322, and 6323 of the Internal Revenue Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the following-named taxpayer. We have made a demand for payment of this liability, but it remains unpaid. Therefore, there is a Tien in favor of the United States on all property and rights to property belonging to this taxpayer for the amount of these taxes, and additional penalties, interest, and Costs that may accrue. Name of Taxpayer ROGER C ER Residence 245 N OUSTER AVE GRAND ISLAND, NE 68803-4220 IMPORTANT RELEASE INFORMATION: For each assessment listed below, unless notice of the lien is refiled by the date given in column (e), this notice shall, on the day following such date; operate as a certificate of release as defined in IRO 6325(a}, NC S.e oT Siq• Jphn p Gals - UCC FTL 8910625322_5 POs; 1 KISER ROGER C F'lled: 04!22/2010 11:18 pM Tax Period Date of Last Dayy for Kind aF Tax Ending Identifying Number Assessment Refifing (a) (b) (~) (d) (e) 1040 12/31/2001 XXX-XX-0096 09/19/2005 10/1'9/2015 Place of Filing Register of Deeds Ha11 PDHOX 1fi92 Grand Island, NE 68802-1692 X002/006 57731.55 Total ~ $ 57731, 55 This notice was prepared and signed at the 13th day of Apri 1 Signature ~ for MICHAEL W. COX CHICAGO, IL 2010 on this, ACS (aoo) $29-3903 V npaid Balance of Assessment 24-00-0008 tnva e: ~eruncate or Officer authorized by law to take acknowledgment is hoc essential to the validity Of Notice Of Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) ' part 1 -Kept By Recording Office Form bb8(Y)(c) (Rev, 2-2004 CAT. NO 60025X