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09/20/2010 MON 15:09 FAX 402 471 4429 UCC SECRETARX OF STATE wy• Hdll Form bb8 (Y)(c) IAav. February 20041 5 Department of the Treasury - Inkernal Revenue : "` s" °' ;t''"°"^ " ~•'• - ucc FTC Notice of Federal Tax Lien Area: Serial Number Fa SMALL Y3USINESS/SELF F:MPIAXED AREA #4 Lien Unit Phone: (8ao) 829-3903 697224110 9930637807-7 Py~: , F'i~edF 09/2020 0,12:43 PM As provided by section 6321, b322, and fi~Z3 of the internal Revenue Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the following-named taxpayer. We have nwde a demand for payment of this liability, but it remains unpaid. Therefore, there is a lien in favor of the United States on all property and rights to property belonging to this taxpayer Far the amount of these taxes, and additional penalties, interest, and tarts that may accrue. Name of Taxpayer THOMAS J CUDDHFORD 2oiooss2~ Residence 3 4 2 3 KELLY ST APT 2 01 GRAND ISLAND, NE 6$$03--1323 IMPORTANT R~I.EASE INFORMATION; For each assessment listed below, unless notice of the lien is refiled by the date given in column (el, this notice shall, on the day following such date, operate as a certificate of release as defined in IRC 6325(a1. Tax Period Date of Last Dayy For Unpaid Balance Kind of Tax Ending identifying Number Assessment Refiling of Assessment a b ~ (c) d (e) (t~ 1,040 12/31/2003 XXX-XX-4822 05/31/2004 06/30/201.4 340.64 Place of Filing Register of Deeds Hail PoBOx 1692 Grand Island, NE 68802-1692 Total I$ 340.64 This notice was prepared and signed at CHICAGO, IL the 07th day of September 2010 X003/003 an this, Signature A Title ACS 24-00-0008 for MICHAEL W. COX (800) 829-3903 (NOTE: Certificate of pfficer authorized by law to ta!<e acknowledgment is not essential to the validity of Notice of Federal Tax lien Rev- Rul. 71-466, 1971 - 2 C-B. 4091 Farm bb8(Y)(c) (Rev. 2-2004) , Par; 1 -Kept 0y Retarding Office CAT. NO 60025X 1f