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05/25/2010 TU8 $: 50 FAX 402 471 4429 UCC SECRETA1tY OF STATE yyy Hilll <br />V~ <br />~O112/Ol)2 <br />1808 <br />Department of the Treasury - Internal Reveriue Service <br />Farm 66$ (Y)(c) Irlotice off' Federal Tax Lien <br />{Rev. October 20401 <br />Area: Serial Number r~r O11t1011Si Ilan 6v Fin4nrrli..n nlRarw- ._.. <br />ne s.s w xt.+• - ucc Fri <br />SMALT,.i $F3SIi;TE35/SELF EMI?IAYED AREA #9 <br />Lien Unit Phone: (8DD) 829-39D3 - - 132199603 <br />AS provided by section 632f, 6322, and 6523 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, 9903ZI:134l;14-1 Past 1 <br />FI ~ PATRICK l- <br />° <br />~ <br />there is a lien in favor of the united States an all property and tights to ira <br />Fi. esr2ema ~ ~ t+a An <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and wets that may atxrve. <br />Name o Taxpayer PATRICK L & RXTA A FITZGERALJJ <br />Residence 1521 W xsT sT 2 010 0 3 5 6 9 <br />GRAND ISLAND, NT fi88D1^5707 <br />IMPORTANT RELEASE INF~RMATIDN: 1"or each assessment fisted below, <br />unless notice of the lien is refiled by the date given in column le), this notice shall, <br />as defined <br />on the day following such date, operate as a..certificate of release <br />__ <br />in IRC 63251®l. - <br /> Tax Period Date of last Dayy for Unpaid Balance <br />Kind of Tax Ending Identifj-ing Number Assessment Refiling of Assessment <br />(a) b c (d) e) f <br />1040 7.2/31/7.995 506-42-87.82 07/21/1997_ 08/20/20D7 2162.77 <br />1,040 12/31/199b 506-42-8182 08/17/1998 09/16/2008 117.45.42 <br />1.040 12/37./199.7 50G-42-8182 11/07./1999 12/D1/2D09 6224.42 <br />1040 12/31/x998 506-42-8,82 10/11/1999 11/1D/2009 3269.91 , <br />7.040 12/31/1999 506-42-87=82 04/15/2~i72 05/15/2012 2116.98 <br />1D4D 12/31/200D 506-42-8182 12/10/2001 01/09/207.2 414.84 <br />.Place of Fling <br />Register fl~ Deeds _ <br />Ha17. POl30X x692 <br />Grand 7:s7.and, NE 6 8 8 02-1692 <br />- Total <br />This notice was prepared end signed at <br />the 29th day of August: <br />5T PAUL, MN <br />2003, <br />Signature ~ ACS <br />fox S KrLPA ICK ~ ~ (80q) 829-3903 <br />2#934.34 <br />i <br />f~ <br />nn this. - j <br />i <br />~ ~ <br />~~ <br />i <br />29-00--ODDB ~~ <br />(NUTtr: Certificate of officer authorized ny lew to take r:cknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev, Rut. 71-~66, 1971 -2 C.B. 409} Form 668(1C)(c) (Rev. 10-00) <br />Part i -Kept $y Recording Office GwT_ Sao soa2sx <br />