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08/03/2010 TU8 14:17 FAX 402 471 4429 UCC SECRETARY OF STATE ~y~ Ha11 <br />Form 668 (Y)(c) <br />(Rev. February 20041 <br />For <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPI,OY1sD AREA #1 <br />Lien Unit Phpne: (8001 913-6050 681882610 <br />As provided by section 63Z 1, 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 an all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional perrakles, interest, and vests that may accrue. <br />Name of Taxpayer KENNETH RAY & SUSAN 1?Av <br />Residence 3p3 W 7TH ST <br />GRAND ISLE, NE 68801 <br />X003/003 <br />Use by Recording pffice <br />NE Sec pT 5lrip John R 6plp -UCC CTL <br />RAY KENNE H6+! Ras; 1 <br />Filsd: 0Bl03l20f0 0f ;00 PM <br />201005456 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (el, this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(al. <br />Tax Period Date of Last Day for <br />Kind of Tax Ending Identifying Number Assessment Reflling <br />a) (b (c) d) (e <br />lo~io 12/31/zoos xxx-xx-ozol 06/o7/2oio a7/o~/2a2o <br />Place of Filing <br />23rd day of July <br />~7~ <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />unpaid Balance <br />of Assessment <br />2931.58 <br />Total ~ $ <br />This notice was prepared and signed at <br />the <br />Signature <br />for R <br />Title <br />MANAGER 21-00-0001 <br />(631) 654-6154 ,~ <br />(nartn: [:ertiticate of officer authorized by law to take acknowledgment Is not essential to the validity of Notice of FederBt lax lien <br />Rev. Rul. 71-466, 1971 • 2 C,B. 409) <br />Part 1 -Kept By Recording Qffite Form 668(Y)(c) (Rev. 2-2004) <br />CAT. NO 60025X <br />CHICAGO, IL <br />2o1Q <br />2931.58 <br />, an this, <br />