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Q9/13/2011 TUE 15:12 FAX 402 471 4429 UCC SECRETARY OF STATE -�-�-� 8a11 <br />s�y� <br />Oepartment of tt�e Treasury - Interna( Revenus Service <br />Form 668 (Y)(c) Notice of Federaf Tax laen � 0110 fi 8 0� <br />(Rev. February 2004) <br />Area: Se�ial IVumber <br />SMAI,L BUSINESS/SELF EMPLOYED AI2EA, #1 <br />Lien Unit Phone: (800) 913-605U 809250311 <br />As provlded by section b32 i, 6322, and 6323 of the Internal Rerrenue <br />Code, we are giving a notice that taxes (inclading ynterest and penalties) <br />have been assessed against the fallowing-�amed taxpayer. We have made <br />a demand far payment of this [iability, but it remains anpaid. T6erefore, <br />there is a lien in favor of the llnited States on atl property and rights to <br />property be(onging tv this taxpayer for the amount of these taxes, and <br />additional penalties, imterest, and costs that may aarue. <br />Residence g�.� ST QAUL � RD APT A <br />GRAND ISLAND, NE 68801.-0000 <br />For Optional Use by Recordi�g Office <br />N6 See af 5!a!e John q Gele - UCC FTL <br />9911671461-7 P9s: 1 <br />RIVERR JUL70 <br />Filed: 08/i3/2011 i2:17 PM <br />��7r VI��A�� ■ na:�.s./'�vr ■atlrv�u'u���va�� r�� GC{HI� O�la��l�l�IlouL u�wu vo�vrv� <br />unless notice of the lien is refiled by tha date given in cofumn ie), this notice shail, <br />on the day following such date, operate as a ce►�tificate of release as defined <br />in IRC 6325(a�. <br />Tax Period Date o# l.ast D�ay for <br />Kind of Tax Ending Identifjr�ng Namtier Assessment ' Refiuing <br />a) (b) (c (d) (e) <br />1040 12/31/2000 XX;X-XX-3496 Q2/21/2005 03�23/2015 <br />1040 12/31./2001 XXX-XX-3496 02/21/2005 03/23/2015 <br />1040 12/31/2002 XXX-XX-3496 �O1/08/2007 02/07/2017 <br />1040, 12/31f2005 XXX-XX-�3496 04f18/2011 05/18/2021. <br />1040 I2/31/2006 XXX-XX-3496 04/18/2011 05/18/2021 <br />Place of Fi{ing <br />Regis�er of Deeda <br />Hall POBOX 1692 <br />Grand Island, NF 68802-1692 <br />Total I $ <br />This notice was prepared and signed at CHICAGO, IL <br />the 22nd day of August 2011 <br />, <br />, on this, <br />Signature � Title <br />REVENUE OFFICER 21-03-4340 <br />for A LEAR.Y (212) 719-SOS4 <br />(NOTE: Certifiaate of afficer authorized by law to take acknowiedgmant is not essentiaf to the valldiry of Notice of Federal Tax lien <br />Rev. Rul. 71-4fi6, 1971 - 2 C.B. 409) Form 668(ln(c) (Rev. 2-2004) <br />Part 1 - Kept By Record�eg O[fice CAT. MO 60025X <br />l�npaid Balance <br />of Asseument <br />�oo2�aoz <br />• 13023.90 <br />32894.58 <br />35390.61 <br />26298.55 <br />7657.45 <br />115265.09 <br />� <br />;'. <br />