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12/03/2010 FRI 13:4$ PA7[ 402 471 4q29 UCC SSCR�TA1tY pF STATE ��� H311 <br />�r� <br />�arm 468 (Y)(c) <br />(Rev. Fe6ruary 2004f <br />Fo� Optional Use bv Recordfnp Office <br />Department of the Treasury - In#emal Revenue Service <br />Notice o# Federal Tax Lien 2 U 10 0 9 0 2 7 <br />Area: Serial Number <br />SMAI,L BUSIN�SS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-60SQ 72329151p <br />As provided by�section b32�1, 6322, and b323 af the Internal Reverwe <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 dcmand for paymrnt of tNis Ilability, but it remains unpaid. Therefore, <br />there is a lien in favur of che llnited 5tates an all property and righa to <br />property betonging to this taxpayer tar the amount of thes� taxes, and <br />additional penalties, interest, and cosrs that may accrue. <br />Name of Taxpayer ANGEL L COLON MENDEZ <br />Residenne 518 W 15T ST <br />GR.AND ISLAND, NE 688p1.-5803 <br />NF See aI 5!e}■ ,1ohn p 6ala - IlC[ FT1. <br />993064443$-3 Psa; 1 <br />COLON MENDEZ RNGEL L <br />Filad: 12l03/2010 09:03 RM <br />�003/003 <br />IMPQRTANT REI,�qS� INFORMATION: �or each assessment listed below, <br />unless notics of the lien is refiled by the date given in co{umn (e), this notice shall, <br />an the .day fotlowing such date, operate as a certificate of retease as defined � <br />in IRC B325(al. <br />Tax Period Date of Last Day for <br />Kind of Tayr Ending Identitying Number Assessment Refliing <br />(a) (�) (�) (d (e <br />1�40 �,2/31/2007 XXX-XX-6531 05/26/2008 06/25/2018 <br />1b.40 12/31/2007 XXX-XX-6531. ].2/07/2009 O1/OC,/2020 <br />Place of Filing <br />�-�r� <br />Register of Deeds <br />Hall POBOX 1692 <br />Gran xsland, NE 6$802-1 <br />unpaid Balante <br />of Assessment <br />3394.81 <br />Total I$ 3 3 94 . 81 � <br />This notice was prepared and signed at <br />the _ 19 day of November <br />cxzr�.co, rL <br />201q <br />, on this, <br />Signature � � Title <br />REVENUE �FFICER 24-1Q-1720 <br />for DANIELLE L MUELL (402) 473--4675 x2912 <br />(N�TE: Certiffcate of vfficer authorized by law to take acknowledgment is not assantial to the validity of Natice of Faderal Tax 1(en <br />Rev. Rul. 71-46fi, 1971 - 2 C,B, 4081 Form 668(Yj(c) (Rev. 2-2004 <br />Part 1- Kepc By Recording �fflce • CaT. NO fi0a25X <br />