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04/22/2010 THL) 14:39 FAX 402 471 4429 UCC SBCRETARX 08 STAT>a ~~~ Hall <br />359 <br />Form 668 (Y)(c) <br />(Rev. February 20p4) <br />Area: <br />WAGE & INVESTMENT AREA #2 <br />L' U P <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien 2 010 0 2 6 8 6 <br />Serial Number For Optipnal Use by Recording Office <br />ien nit hone. (800) 824-7650 6439748].0 <br />As provided by section 6321, 6322, and 6323 of the internal Revenue <br />Code, we are gluing 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 costs that may accrue. <br />Name of Taxpayer MARIO CRUZ JR <br />Nfi Sit of 5}•}a John q 6+~@ ~ uCC KTL <br />99308213323-7 pss; 1 <br />~11edM 0422 2010 11:18 AM <br />Residence 2 815 W WAUGH ST <br />GRAND ISLAND, NE 68803-1747 <br />Tax Period Date of Last Dayy for <br />Kind of Tax Ending identifying Number Assessment Refiling <br />(a) (b) c) d e) <br />1040 12/31/zoo6 xxx-xx-1632 io/o2/coos ~.~/01/2o1s <br />1040 12/31/2007 XXX-XX-7.632 11/30/2009 ].2/30/2019 <br />IMPORTANT RELEASE INFORMATION: Far each assessment listed below, <br />unless notice of the lien is refiled by the date given in oolumn (e); this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in tRC 6325(a). <br />Place of Filing <br />Register of Deeds <br />Ha11 PpSOX 1692 <br />Grand Island, NE 68802-1692 <br />Unpaid Balance <br />of Assessment <br />3775.86 <br />5760.50 <br />Total ~$ 9536.36 <br />This notice was prepared and signed at <br />the 13th day of April <br />Signature <br />for SUSAN M <br />~. ~ <br />EDITH <br />fd1003/OU6 <br />on this, <br />ACS <br />(800) 829-7650 <br />14-00-0000 <br />~.....~. r.c~uncow ~~ unicn~ auuivnzeo vy law to taKe acKnpwiatlgment is not essential to the validity of Notice of Federal Tax lien `n <br />Rev. Rul. 71-466, 1971 - 2 C.6. 409) Farm 6b8(Y)(t) (Rev. 2-2004) I///~~~\\'`~t/j <br />Part 1 -Kept 8y Recording Offite CAT, NO 60025X \ y' <br />2010 <br />CHICAGO, IL <br />