Laserfiche WebLink
09I08J2011 THU 15:07 FAX 402 471 4429 UCC SECRETARY OF STATE y~ � Ball <br />� �� <br />Form 668 (Y)(c) <br />(Rev. February 20041 <br />Department of the Treasury - Interna! Revenue Service <br />Notice of Federa! Tax Lien <br />Area: Serial Number For Optione <br />SMALL BIISINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 810625711 <br />As provided by section 632 t, 6322, and 6323 of tf�e lnternal Rovenue <br />Code, we are giving a notice that taxes (inctud�ing interest and penatties) <br />have been assessed agai�st the following-named taxpayer. We have made <br />a demand for payment pf this liability, but h remains anpaid. Therefore, <br />there is a lien in favar of the llnited States on aU property and rights to <br />property belonging to t6is taxpayer for tbe amount of tLese taxes, and <br />additioaal penalties, interest, and costs that may aarue. <br />Name of Taxpayer BETHANY ROZENDAL <br />Residence 612 W 16TH ST <br />� GRAND ISLAND, NE 68801-3514 <br />IMPORTANT RELEASE lNEORMATION For each assessment list�d below, <br />unless notice of tha lien is refiled by the date given in column (e1, this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325ta). � <br />Ta�c Period � Date of Last Day for <br />ICind of Tax Ending ldentifyaig Number Ass�ssment Refil'mg <br />(a3 (b) (�) d) (e) <br />l04o za/�i/aoo9 xxX- XX-9298 07/25/2011 08/24/2021 <br />Zo4o ia/31/aoio �x-xx-ga9s o�/i8/aoii os/i�/ZOal <br />a <br />Place of Filing <br />1 <br />Use <br />686.28 <br />4730.36 <br />Register of Deeds <br />Ha11 POBOX 1692 <br />Grand Isl.and, NE 68802-1692 <br />�o1�os;oo <br />To.tal � $ 5416 . 64 <br />This notice was prepared and signed at <br />the 26th day of August <br />CHICAGO, ZL <br />2Q11 <br />, on this, <br />Signature ���� Title <br />REVENUE OFFICER 24-10-1720 <br />for DANIELLE L MUELLE (402} 473-4675 x2912 <br />(NOTE; CeRificate of officer authorized by law to take acknowledgment is not esseniiel to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(n(e) (Rev. 2-2004) <br />_ ParL 1- Kept By ltecordiog Office CAT. P10 60U25X ` r , <br />W <br />�ooz/oo3 <br />Office <br />- ucc Fr� <br />1 f0:33 AM <br />Unpaid BaWnce <br />of Assessment <br />, <br />