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06/2812011 TUE 15:12 FAX 402 471 �429 UCC SECRETARY OF STATS -+ay 8a11 <br />�� Form 668 (Y)(c) <br />tAev. February 2004) <br />�J005/006 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federaf Tax 1.ien 2 0:� 10 4 814 <br />Area: Seriai Number � <br />SMALL BIISTNESSjSELF EMPLOYSD AREA #�1 <br />Lien Unit Phone: (800) 913-6050 795006011 � <br />As provided by section 6321, b322, and 6323 of the Internal Revenue ; <br />Code, we are giving a notice that taxes (including interest and peAalties) I <br />have besn auessed against the foUowing named taxpayer. We have nwde <br />a�demand for payment of tf�is li�ability, but it remains uepaid. Therefore, <br />there �S a lien in favor of th� [Inited State� on a!1 property and �igbts to <br />property 6elonging w rhis taxpayer for the amaw�t of these taxes, and <br />additional penalties, interest, and costs that may aarue. <br />ame <br />Residence 435� GJ CAPITAL AVE <br />GRAND ISLAND, N6 68803-1415 <br />IMPORTANT RELE�ISE INF�RMATIDI�I: For each assessmerrt listed helow, <br />unless notice of the lien is refiled by the date given in column (e1, this notice shall, <br />on ihe day foilowing such date, operate as a cartificate of release as defined � <br />in IRC 6325(a1. <br />� Tax Period Date of I.ast D for <br />Kind of Tax Ending Identifying Number Assessment RefiC�g <br />104d <br />1040 <br />1040 <br />1040 <br />1040 <br />104 0 <br />1040 <br />1040 <br />1040 <br />1Q40 <br />1040 <br />1040 <br />1040 <br />1040 <br />1040 <br />Place of Filing <br />XXX-XX-2602 <br />XXX-%X-2602 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-2642 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXR-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-2602 <br />XXX-XX-26Q2 <br />04/18/2011 <br />02/28/2011 <br />03/o�/aols <br />02/21/2011 <br />03/47i2011 <br />02/07/2011 <br />O1/03/2011 <br />12/27/2010 <br />02/20/2006 <br />12/27/2010 <br />02/07/2011 <br />02/16f2009 <br />02f07/2011 <br />02/16/2009 <br />02/07/2011 <br />05/18/2021 <br />03/30/2021 <br />04/Q6/2021 <br />03f23/2021 <br />04/a6/2021. <br />03/09i2021 <br />02/02/2021 <br />O1/26/20.21 <br />03/21/2016 <br />O1/26/2021 <br />03/09/2021 <br />03/18/2019 <br />03/09/2021 <br />03/18/2019 <br />03/09/2021 <br />PII CF�iEL K <br />06/28/2011 11:28 RM <br />unpaid Balance <br />of Asses�ment <br />17658.92 <br />99522.49 <br />47631.96 <br />23124.78 <br />22036.28 <br />11286.15 <br />23917.54 <br />24688.66 <br />24330.82 <br />26373.69 <br />23328.72 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 688 <br />Total �$ 343900.01 <br />This notice was prepared and signed at �ICAGO, IL <br />t �� 21st day of J� e 2011 <br />Signature <br />Titie <br />RE'VENU� OFFICBR <br />, on this, <br />24-10-1744 <br />for PATRICR J KELLO �(308� 384-4850 <br />(NOTE: Certfficate of officer authorized by lew to take acknowledgment is not esssntial to the va{idity of Notice of Federat'fax lien <br />Rev. Rui. 71-466, 1.871 - Z C.B. 409i Fqrm 4b8 i �p9�v. Z- 4) � <br />PaCt !� K�� �,i R�tii`�t� Qt� ���° IFi� ����� <br />12/31/1993 <br />12/31i1994 <br />12/31/1995 <br />12/31/1996 <br />12/31/1997 <br />12/31/199$ <br />12/31/1999 <br />12/31/2001 <br />12/31/2003 <br />12/3l/2003 <br />12/31f2003 <br />12/31/2004 <br />12/31/2004 <br />12/31/2005 <br />12/31/2005 <br />�,,...... ,.. -. _� - -.. _:.: <br />