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02/16/2011 W8D 1b:42 FAX 402 471 4429 UCC 5ECRSTARY OF STATS ��� Hall <br />Form 6b8 (Y)(c) <br />(Rev..February 2004) <br />3592 <br />Departme�t of the Treasury - tnternal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Seriat Number <br />SMALL BUSINESS/SELF EMPIAYED ARgA #4 <br />Lien Un+t Phone (800y 829-3903 750854711 <br />As provided by section b321, 6322, and 6323 oE the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the fotlowi�g-named taxpayer. We have made <br />a detnand for payment of this fiability, but it remains unpaid. Therefore, <br />there is a lien in favor af the 1lnked States on ait property and riglnts to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additi penalties, int a c tha may accru <br />Name of Taxpaver TERRY A RAWLINGS <br />Residence 173 3 S BLA�NE ST <br />C#RAND ISLAND, NE 68803-6152 <br />�006/006 <br />Fo� <br />� IMPQRTANT RE6EASE INFORMATION For each assessment listed below, <br />uniess notice of the lien is refiled 6y the date given in cofumn te), this notice shall, <br />on the day fallowing such date, operate as a certificate of release as de�ned <br />in IRC 6325(a). ' <br />Tax Period Date of Last Day for <br />Kind of Ta�c � Ending Identifying Number � Assessment Ref�ling <br />1040 12/31/2004 <br />1040 12/31j2006 <br />1040 12/31/2007 <br />Place of Filing <br />x�-� -0360 �a/os/aoos oi/o�/aox9 <br />XXX-XX-0360 05/11/2009 06/10/2019 <br />XXX-XX-0360 05i24/2010 06/23/202Q <br />41473.12 <br />30b71.44 <br />22521. 8'7 <br />Register of Deeds " <br />Hall POBOX 1692 <br />Grand Island, NP 68802-1692 <br />Total {$ 94666.43 <br />This notice was prepared and signed at <br />the 04th day of February <br />Signature <br />for MICHAEL W. COX <br />CHICAGO, IL <br />2011 <br />l�se <br />Office <br />�.�. ................... p� t <br />iS1626-3 � <br />VGS TERRY R <br />; 02/1gf20i1 02:35 PM <br />201101��� <br />Unpaid Batance <br />of Assessment <br />, on this, <br />Title <br />ACS SBSE <br />(800) 829-3903 <br />24-00-0008 <br />(NOTE: Certificate of officer authorized by law to take acknowtedgment is not essential to the validity of Notice of Federal7ax lien <br />Rev. Rui.'71-466, 1971 - 2 C.B. 409) Fotm 668 <br />' Part 1- Kept By Recording Office (�(�) SRev. 2-2004i <br />CAT. NO 60025X <br />