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03/23/2011 WED 15:39 FAX 402 471 4429 UCC SECRETARY OF STATS <br />� <br />fl Form 668 (n(c) <br />(Rev. February 2004) <br />Area: <br />sr�L --svs t� ss / sEVF - �rt�LO� <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federa[ Tax Lien <br />Se�ia1 Number 'NE Se� ,� 5 <br />Lien Unit Phone: (8U0) 913-6050 I 76537771i <br />As provlded 6y section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are g'rving a notice that taxes (inctuding interest and penalties) <br />have been assessed against ihe following-named taxpayer. We have made <br />a demand for payment of this {iabittty, but it remains unpaid. Therefiore, <br />there is a lien in favor of the llnited States on all property and rights to <br />property be[ongeng to th�s wxpayer #or the amount of theu taxes, and <br />additiona! penalties, interest, and costs that may accrue. <br />Name of Taxpayer MICHAEL J LIBBIE L PUNCOCHAR <br />Residence 2231 W 11TH ST <br />GRAND ISLAND, NE 68803-3621 <br />IMPOR1'ANT RELEASE INEORMATION For ea�h assessment listed below <br />unless notice of the lien is refiled by the date given in calumn (e), this notice shall, <br />on the day fiollowing such date, operate as a certificate of reEease as defined <br />in IRC 6325{a), ' <br />Tax Period Date of last Day for <br />Kind of Tax Ending identifjiirtg Number Assessment Retlling <br />(a) (b) (t) � (a) fe) <br />�.040 12/31/2009 XXX-XX-999$ li/oi/zaio la/ol/zo2a <br />Place of Filing <br />�.�r� <br />Register of Deeds <br />- Hall POB�X 1692 <br />Grand Island, NE 68802-Z692 <br />t� Jd.w A Galo � !1[[ <br />4911654749-6 Pg <br />PUNCOCHHR MICHREL J <br />Filed: 03l23/2011 te:tT R!7 <br />�004/005 <br />23587.32 <br />7otal I$ 23587.32 <br />This notice was prepared and signed at CHICAGO, IL <br />the llth day of Max'ch 201I <br />. <br />, on this, <br />Signature Title <br />�� ACS SBSE 24-00-00�8 � <br />for MICHAEL W. COX (840} 82g-3903 <br />(NOTE CeRifiCatB of officer authorized by law to take acknowledgment is not essentiat to the validity of NotiCe of Federel Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(t) (Rev. 2-20041 <br />Put 1- Kept By Retordiag O�ce. CAT. NO 60025X <br />' � <br />2011023�0 <br />llnpaid Balance <br />of Atsessment <br />