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07/27/2010 TUE 15:33 FAX 402 471 4429 UCC SSCRBTARX OF STATE ~~~ Hall <br />G~ Form 668 (Y) c <br />() <br />(Rev, February 2004) <br />X002/002 <br />Area: <br />WAGE & INVESTMENT A}2EA #2 <br />Lien Unit Ph <br />Department of the Treasury -Internal Revenue Service <br />Notice o~ Federal Tax Lien <br />Serial Number For Optiana <br />One. (800) 829-7650 67$536510 <br />As provided by section 6321, b3Z2, and &323 of the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following~named taxpayer. We have made <br />a ~ demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costa that may accrue. <br />Vame of Taxpayer HECTOR RUIZ <br />Residence '720 E 9TH ST APT 2 <br />GRAND ISLAND, NE &8801-2770 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed belaw, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a-. <br />Use by Recording Otfiae <br />NE ;ae of iiala John ~ 8r.lr - L1CC F7L <br />9910633133-4 Ps$: 1 <br />RUTZ HECTOR <br />Filed: 07/27/2010 11:31 RM <br />201005224 <br />Tax Period Date of Last Day for <br />Kind of Tax Ending Identifying Number Assessment Refilling <br />._. ,.. - <br />1040 12/31/2005 XXX-XX-3116 03/16/2009 04/15/2019 <br />1040 12/31/2006 XXX-XX-3116 03/16/2009 04/15/2019 <br />Unpaid Balance <br />of Assessment <br />1097.93 <br />25504.35 <br /> <br />4 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total $ <br />Grand Island, NE 68802-1692 <br />26602.28 <br />This notice was prepared and signed at CHICAGO, IL <br />the 15th day of `71.11y 2010 <br />on this, <br /> <br />Signature ~ <br />for SUSAN MEREDITH <br />ACS <br />(800) 829-7650 <br />14-00-0000 <br />--- <br />~ y aw o a e ac now a gment ~s not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409- <br />Form f68(Y)(c) (Rev. 2-2004 '` !~ <br />Part f -Kept BY Recording Office CAT. NO 60025X <br />