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06/08/2010 TUI3 13:39 Fax 402 471 4429 UCC SECRETARY OIr STATE -~yy Hall <br />8807, <br />Department of the Treasury -Internal Revenue Service <br />Form 668 (Y)(c) <br />IRev. February 20041 Notlce of Federal Tax Lien <br />Area: Serial Number For Optional Use by Recording Office <br />SMALL BUSINESS/SELF EM9?LOXF..I) AREA #4 ' <br />Llen Unit Phone: (800) 913-6050 661812210 NE s.~ oP Skeke John p a.la - ucC FTL <br />/4s provided by section 6321, 6322, and 6323 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 far 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 8910629423-3 Pga: ~ <br />property belonging to this taxpayer for the amount of these taxes, and OLSON NDRRIS 9 <br /> <br />additional penalties, interest, and costs that may accrue. Fi.,ted: 06/09/2010 09;04 RM <br />Name of Taxpayer NORRIS B & JANE E OLSON . <br />Residence Po Box 512 2 010 0 3 9 5 3 <br />KEARNEY, NE 68848-0512 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless nptice 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 6325(a). <br /> Tax Period Date of last Dayy for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />(a (b (c) (d (e) ~ <br />7.040 12/31/2000 Xxx-XX-2854 06/08/2009 07/08/2019 62803.82 <br />7.040 12/31/2001 XXx-xX,-2854 07/13/2009 08/12/2019 109590.D4 <br />1040 12/37./2002 XXX-xX-2854 06/29/2009 07/29/2019 8879.13 <br />X040 12/3]./2003 XXX-XX-2854 06/29/2009 07/29/2019 39644.42 <br />1040 12/31/2004 XXX-XX-2854 D6/29/2009 p7/29/2019 42856.56 <br />1040 7.2/31/2005 XXX-Xx-2854 06/29/2009 07/29/2019 6297.77 <br />104D 12/31/2006 XXX-Xx-2854 0$/7.0/2009 09/09/2019 3690.23 <br />1040 12/37,/2007 XXX-XX-2854 06/01,/2009 07/01/2019 30061.48 <br />1040 12/31/2008 XXX-XX-2854 08/03/2009 09/02/207.9 567.01 <br />Place of Filing <br />Register of Deeds <br />Hall POS~X 1692 Total $ 304390.46 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />the 28th day of May <br />X004/007 <br />CHICAGO, IL <br />2010 <br />on this, <br />Signature ~ H <br />ft7r M1rCHAEL W PONTR <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br />24-10-1737 <br />(TiOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 79.486, 1971 - 2 C.B. 409) ~ Form 668(10(c) (Rev. 2-2004) <br />Part 1 -Kept ey Recording Office CAT. NO fi0025X <br />