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08/24/2010 TUE 10:34 <br />Form bb8 (Y)(c) <br />{Rev. February 2004) <br />FAX 402 471 4429 UCC SECRETARY OF STATE yyy Hall <br />""~°'~ Serial Number <br />SMP,LL BUSINESS/SELF EMPLOYED AR~1 #4 <br />!_ien Unit Phone: (800) 913-6050 6878403~.U <br />As provided by section b321, 6322, and 6323 of the internal Revenge <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the fallowingw~amed 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 cep property and rights to <br />property belonging to this taxpayer far the amount of these taxes, and <br />additional penalties, interest, and casts that may accrue. <br /> <br />_. <br />Residence '77,0 yr) 13TH ST <br />GRAND ISLAND, NE 68801-3628 <br />For Optional Use 6y Recording Office <br />Ni Sea of 5k~ke John A rN~f - I1CC F71. <br />99108354$6-3 pgs; 1 <br />STOBBE ALLAN D <br />Fii~d: 08/24/2010 09:00 AM <br />IMPORTANT RBI,EASE INFORMATION: For each assessment listed b <br />l <br />e <br />ow, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall <br />, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br /> <br />Kind of Tax Tax Period <br />finding <br />Identifying Number Dave of <br />Assessment t.ast Dayy for <br />Reli6ng <br />(a) b (c d) (e) <br />104D 12/31/2003 XXX-XX-9$85 03/29/201D 04/28/202D <br />1040 ].2/31/2D04 XXX-XX-9885 03/29/2010 04/28/2020 <br />1040 1.2/31/2005 XXX-XX-9885 03/29/2010 04/28/2020 <br />Place of Filing <br />2oioo~9s$ <br />Unpaid Balance <br />of Assessment <br />4134.57 <br />4292.74 <br />fi_ 417.7.19 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-7,692 <br />Total ~$ 12544.5Q <br />This notice was prepared and signed at <br />the 11th day of August <br />CHICAGO, IL <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />2010 <br />Signature ~ y. ~~- <br />for DANIELLE L~MUELLER <br />Title <br />REVENUE OFFICER 24-10-1720 <br />(402) 473-4675 x2912 <br />X003/009 <br />on this, <br />g' <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-4fifi, 1971 - 2 C.B. 409) Form 668(lf)(e) (Rev, 2-2004) <br />Parr t -Kept By ReCOMfng OFEite CAT. NO fi0025X <br />