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08/09/2011 TU$ 15:Q6 FAX 4Q2 471 4429 UCC SECRLTARY OF STATE ~~� Hall <br />l�J <br />Form 668 (Y)(c) <br />(Rev. Februery 20Q41 <br />�ooz�oos <br />Department of the Treasury - Internat Revenue 5ervice <br />Notice of Federal Tax lien 2 0110 5 9 2� <br />Area; Seria( Number <br />SMALL BUSINESS/SELF EMPLOXED AREA #1 <br />Lien Unit Phone: (.800) 913-6050 804765611 <br />As provided 6y sectioe 63Z 1, 6322, and 6323 of the lnternal Revenne. <br />Code, we are giviing a notice that taxes (inclading interest and penalt�es) <br />have becn assessed agam,:t the following�-named taxpayer. We have made <br />a demand for payment o# this IfabiUty, 6at it remains unpaid..Therefore, <br />ti�ere �S a[ien in favor of the united States on aii property and rights to <br />property belon�fmg to tl�fs taxpayer for the amount of t6ese ta�ces, and <br />addi pena[ties, inter a n d wsts t hat may accr <br />Name of Taxpayer JULTO RIVERA <br />Residence g�,'7 ST PAIIL RD <br />'GRAND TSLAND, NE 688�1-0000 <br />IMPORTA�IT RELEASE IWFORMATION For each assessment listed helow <br />unless notice of the lien is refiled by the date given in column (e), this notice shell, <br />on the day following such date, operate es a certifica#a of release as defined <br />in IRC 8325{a). <br />Tax Peryod �.Date of Las�t� Day for <br />Kind of Ta�c Euding ldeutifying Number Asseument Refiiling <br />1040 12/31/2000 XXX-XX-3496 02/21/2005 Q3/23/2015 <br />1040 12/31/2001 XXX-XX-3496 02/21/2005 a3i23/2015 <br />1040 12/3Z/200.2 XXX-XX-3496 01/0$/2007 02/07/2017 <br />1040 12/31/2005 XXX-XX-3496 04/18/2011 0.5f18/2021 <br />1040� 12/31/2006 XXX-XX-3496 04/18/2011 05/18/2021 <br />Place of Filing <br />Total � $ 115253 . 09 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, N 6880 <br />Use 6v Racordina Of�ice <br />' Sisle lohn R Oale - IJCC FTL <br />8760-6 Pes: 1 <br />Jlri.Io <br />08/09l2011 09:60 RPI <br />Llnpaid Balance <br />of Asse�ment <br />13011.90 <br />32894.58 <br />35390.51 <br />26298.55 <br />7657.45 <br />This notice was prepared and signed et <br />the 02nd day of August <br />CHICAGO, IL <br />2011 <br />, 011 'C�113, <br />Signature . � � Title <br />REVENUE OFFICER 21-03-4340 <br />for A LEARY (212} 719-8054 <br />(NOTE: Certificate of offlcer authorized by law to take acknowledgment is not essential to the vatldity of Notice of Federal 7ax lien <br />Rav. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2-20Q4! <br />Part t- Kept By Raording Oftice � CAT. IVO 60026X <br />� <br />' <br />�t <br />�. <br />€ <br />t <br />f <br />��. <br />V� <br />