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06/23/2011 THU 15:13 FAX 402 471 4429 UCC SECRETARY OF STATE Hall <br />3592 <br />Form 668 i;Y)(c) Department of the Treasury - Internal Revenue Service <br />(Rev. February 2004) Notice of Federal Tax Lien <br />201104'703 <br />Area: <br />Serial Number <br />For Optional Use by Recording Office <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 - <br />792649211 <br />As provided by section 6321, 6322 <br />and 6323 of the Internal Revenue <br />N9 S <br />f S. <br />. <br />J <br />h <br />, <br />Code, we are giving a notice that taxes (including interest and penalties) <br />ee o <br />. <br />. <br />o <br />n A Gals - UCC FTL <br />have been assessed against the following-named taxpayer. We have made <br />a demand for. payment of this liability, but it remains unpaid. Therefore, <br />I <br />there is a lien in favor of the United. States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />II <br />additional penalties, interest, and costs that may accrue. <br />9911664795-5 P9s: 1 <br />ROZENDAL BETHANY <br />Filed: 06123/2011 08:41 AM <br />Name of Taxpayer BETHANY ROZENDAL <br />,BRIGHT BEGINNINGS <br />Residence 115 W CHARLES ST <br />GRAND ISLAND, NE 68801-6020 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below <br />, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Kind of Tax <br />Tax Period <br />Ending - <br />Identifying Number <br />Date of <br />Assessment <br />Last Darr for <br />Refiling <br />Unpaid Balance <br />of Assessment <br />(a) <br />(b <br />(c <br />(d) <br />(e) <br />(f) <br />940 <br />12/31/2010 <br />20-3998975 <br />05/09/2011 <br />06/08/2021- <br />4743.53 <br />941 <br />03/31/2010 <br />20-3998975 <br />04/25/2011 <br />05/25/2021 <br />1704.20 <br />941 <br />06/30/2010 <br />20-3998975 <br />04/25/2011 <br />05/25/2021 <br />5488.69 <br />941 <br />09/30/2010 <br />20-3998975 <br />04/25/2011 <br />05/25/2021 <br />5654.76 <br />941 <br />12/31/2010 <br />20-3998975 <br />05/16/2011 <br />06%15/2021 <br />76.65 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Total 17667.83 <br />This notice was prepared and signed at <br />CHICAGO, IL <br />the 10th day of June 2011 <br />, on this, <br />Signature Title <br />REVENUE OFFICER 24-10-1720 <br />for DANIELLE L IWUELLER-~ (402) 473-4675 x2912 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rut. 71-466, 7971 - 2 C.B. 409) . Form 668(Y)(c) (Rev. 2-2004) <br />Part 1 - Kept by Recording Office CAT. NO 60025X <br />0003/003 <br />