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04/20/2011 W8D 15:25 FAX 402 471 4429 IICC SBCAETARY OF STATE -�-+� Hall <br />� 1� <br />Eorm 668 (Y)(c) <br />(Rev. FObruary 20041 <br />Department of the Treasury - internal Revenue Service <br />Notice of Federal Tax Lien <br />Hrea: Serial Number <br />SMALL $USINESS/SEI,F �LOY3iD AREA #4 <br />Lien Unit Phone: (B00} 913-6050 773353211 <br />As provided by section 6321, 6322, and 6323 of the lnternal Revenue <br />C.ode; we are giving a notice that taxes (inclading �imterest and penalties) <br />have been assesscd against the fo[[owing-named taxpayer. We have made <br />a demand� for payment of this liabil�ty, but it remains unpaid. Therefore; <br />there is a lien in favor vf tf►e Unit�d States on all properr�y and rights to <br />property belong�mg to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and �costs that may accrue. <br />Name of Taxpayer JEFFREY M REIS . <br />Residence 4145 MAIITCHESTER RD <br />. GR.AND ISLAI�ID, NE 68803 <br />For Oational Usa bv Recordinn Office <br />(�003/008 <br />9 ' Pasa 1 <br />M <br />2011 02:32 P{9 <br />201103041� <br />[MPORTANT RELEASE MFORMATION For each assessment listed below, <br />unless notice of the lien ls refiled by the date given in column (e), this'�otice shall, <br />on the day following such date. operate as a certificate of release as defined <br />in IRC 6325ta). • <br />Tax Per�od � Date of l.ast D�ay for <br />Kinc1 of Tax Ending Identifying Namber Asseument Ref7'mg <br />6672 06/30/2009 XXX-XX-724.7 12/27/2010 01/26/2021 <br />6672 09/30/2009 XXX-XX-7247 12/27/2010 O1/26/2021 <br />6672 12/31/2009 XXX-XX-7247 12/27/2010 O1/26/2021 <br />6672 03/3I/2010 XXX-XX-7247 12/27/2010 01/26/2021 <br />Place of Filing . <br />Register of Deeds <br />Hall POBOX 1692 <br />. Gr and Island, NE 68802-1692 <br />Unpaid Balance <br />of Auessment <br />3570.24 <br />4220.26 <br />2746.98 <br />2178.70 <br />Total � $ 12716 .18 <br />This notice was prepared and signed at • <br />.� 06th day of April <br />CHICAGO, IL <br />2011 <br />, on this, <br />Signature ./ � Title � <br />RE�TENUE OFFICER 24-10-1720 <br />for DANIELLE L MIIELL • . (402) 473-4675 x2912 <br />(NOTE: Certificate of officer authorized by law to teke acknowledgment is not essentiel to the vaUdiry of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) • • <br />- Part 1- Kepc By ltecordtns �� �� 668(ll)(c) (Rev. 2-20 <br />CAT. P10 60025X <br />h <br />