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04/22/2010 TH[] 14:39 FAX 402 471 4429 UCC SECRETARY OF STATE »~~ Ha11 1004/006 <br />3592 <br />Department of the Treasury -Internal Revenue Service <br />Fornn ddb (Y)(c) 2 010 0 2 6 8 7 <br />(Rey. February Zoa4- Notice of Federal Tax Lien <br />Area: Serial Number For Optional Use by Recording Office <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 643979310 <br />As provided by section 6321, 6322, and 6323 of the Infernal Revenue <br />Cade, 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 costs that may accrue. <br />ame of I axpayer <br />Residence 2,504 pARKVIEW DR <br />GRAND ISLAND, NE 68801-7570 <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 f3326(a). <br />Tax Period <br />Kind of Tax Ending <br />1040 12/31/2000 <br />1040 12/31/2002 <br />1040 12/31/2003 <br />1040 12/31/2004 <br />Place of Filing <br />Identifying Number <br />(c) <br />XXX-XX-5866 <br />XXX-XX-5$66 <br />XXX-XX-5866 <br />XXX-XX-5866 <br />NC See of S!~!^ Jahn p qpQ e[C FTG <br />s810C2S324-9 Pps: 1 <br />WENTX JAMES <br />Filed: 04/22/2010 11:18 AM <br />Date of Last Dayy fvr [unpaid Balance <br />Assessment Refiling of Assessment <br />(d) a (f <br />10/06/2003 11/05/2013 4258.62 <br />08./01/2005 08/31/2015 9730.50 <br />10/29/2007 11/28/2017 17559.61 <br />10/29/2007 11/28/2017 5518.39 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total ~$ 3 7 0 6 7 .12 <br />This notice was prepared and signed at CHICAGO, IL <br />the <br />Signature <br />13th day of April 2010 <br />---_.... <br />on this, <br />for MICHAEL~W. COX <br />Title <br />ACS <br />(800) 829-3903 <br />24-00-0008 <br />(HU1 t: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) 5 <br />Part t .- Kept lay Recording Office Form b68(Y)(c) (Rev. 2-2004 _ <br />CAT. NO 60025X <br />