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O1/07/2011 FRT 15:42 FAx 402 471 4429 UCC 5�CRETARY OF STATE <br />/� — ____. <br />Form 6b8 (Y)(t) <br />(Rev. February 20p4) <br />Area: Serial Number <br />WAGE & II�TVESTMENZ` AFtEA #2 ' <br />Lien Unit Phone: (sod) 829 736449150 <br />As pravid�d by section 6�Z1, 632�, and b323 of the Internal Revenue <br />Code, we awe girving a rrotice that taxes (1nCiuding interest and penalties) <br />hav� been auessed against the fofbrving-named taxpayer. We ieave made <br />a demand far payment of this liabtlity, b�t it remains unpald. Therefare, <br />there is a lien in favor of the Uni��d States on atl property and rights to <br />praperty belong3ng tu this taxpayer for the amount vf these taxes, and <br />additionai penalties, interest, and tosu that may accrue. <br />Name of Taxpayer J05E �` QUILES HERNANDEZ <br />Residence 41 g W 11TH ST <br />GR.AND ISLAND, NE 68801-3734 <br />IMPORTANT REL�ASE INFORMATION Far each assessrrtent iisted below, <br />unless notice of the lien Is refiled by the date given in calumn (e?, ihis notice shall, <br />on the day follpwing sUCh dat6, operate as a certificate of release as dafined <br />in IRC.6325(a). <br />Kind nf Tax <br />1Q40 <br />Place of Filing <br />Fo� OpUonal use ny t[ecoramg utt�ce <br />Nfi ;eu af S��la dah� f1 dsla - �1CC FTL <br />9911847554-4 P9 � <br />QIJILE5 NERNiif�EZ dO5E ,7 <br />Filed: 07/07l2pti 08:26 qM <br />I�ooz�ooa <br />Tax Period� I I Date of � I.ast Day for <br />Ending 4 Identifjr�ng Nrrrnber Assessment ReBling <br />12/31/2007 XXX-XX-41.76 �08/d2/20ZOI 09/O1/2020 <br />R�gister of Deeds <br />Hall �'OBOX 1692 <br />Grand IS1and, NE 688p2-1692 <br />12732.17 <br />'�otal �$ 12732.17 <br />This notice was prepared and signed at <br />CH�C�1G0, IL <br />, on this, <br />#he 29th day of D�� embex' 201Q <br />Signature <br />far PAMELA J ROGERS <br />A�CS <br />(800) 829-7650 <br />14-00-a040 <br />(NOTE: Certificate of offlcer authorized by lew to t�ke ecknawiedgment is not essential to the validity of Notice of Federal Tax lien <br />Rev- Rul_ 71-466, 1971 - 2 C.B. A09) Form 668(1�(c) IRev. 2-2004) <br />Part 1- ICept BY ��ording Oifice CAT. NO BOQ25X <br />92 <br />Departmsnt of the Treasury - internal Revenue Service <br />Notice o� Federal Tax i.ien <br />2o�.a.00�5� <br />Unpaid Salance <br />af Asse�sment <br />