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11/OS/2011 TU$ 14:46 <br />.� <br />FAX 402 471 4429 UCC SECRETARY OF STATE -�-�� Hall <br />I <br />�003/-003 <br />Department of the Treasury -;s�t�rna� �ever►�e Service <br />Eor� 6d8 (Y)(c) <br />(Fta�i. Fe�ruary 20041 � otice ssf ��et�er�� �'�� �.�e� <br />Area: T Serial !�i.��•iscr <br />WAGE & IN\,'RSTMENT AREA #2 ` <br />Lien Unit Phone: (�oo) 829 � � a25bc'77'�. <br />As provided by section 6321, 6322, a�d �5323 a� �hg l�r�eF�ai {��wenue <br />Code, we are giving a notice that taxes (incle�dan� isater�t a� � per��6�ies) <br />have been assessed against the following-nar�ed �:�:c�yer. �� �:v�� ��ac�� <br />a demand for payment of this liability, but it re�aE�.s u����c�.. '�#����w��, <br />there is a lien en fayor of the llnited States on all pr�p�rl�r ��5r� �a,a�►.s t� <br />property belonging to this taxpayer for the amounE o� �hes� s��as, az�� <br />ad(c�itional penaities, �interest, and costs that may a€c���. <br />�;�� vf Taxpayer <br />Residence p0 BOX 2543 <br />GRAND ISLAND, NE 6860z--25�3 <br />1MiPOItTANT RELEASE tNFORMATION For eac1� assessrrant ias:FCi .`�s1���, <br />uNess notice of the lien is refiled by the date giver ir; co���.�zr� {e1, t4�;; �:otie� s:�ai;, <br />on the day following such date, operate as a cer:iticaia oi su9e�s<: as ��`' :c{: <br />in IRC 6325(a). <br />I�ir��7 ts� Tax <br />��� <br />1Q4t3 <br />sa4a <br />1040 <br />104 0 <br />I040 <br />1��� <br />1040 <br />1040 <br />1�40 <br />1.040 <br />Place of Filing <br />Tax Period <br />Ending <br />12/31/199? <br />iz/31/a000 <br />12/31/2002 <br />12/31/2003 <br />7.2/31/2004 <br />12/31/2005 <br />12/31/2006 <br />I2/31/2007 <br />12/31/2009 <br />�.2/31/2010 <br />Identifying i�umber <br />(�) <br />XXX-XX-968� <br />�x-�-��sa <br />XXX-XX-968L� <br />XXX-XX-968� <br />XXX-XX-�6�£: <br />XXX-XX-968;� <br />XXX-XK-968�? <br />XXX-XX-O688 <br />XXX-XX-9688 <br />XXX-XX-9688 <br />���+� o� '� <br />eA�ss�ssm�r�t <br />�d7 _.. <br />"%j2'iJ%�+�� <br />l.t. <br />-� z < <� ; . ;,_�� <br />,� , <br />0tij�3l:�i►:�4 <br />;? s� / ,� ;.t ! 7 �,j l s; <br />, <br />1 �� � r : �.�.;s <br />��f. �. <br />, <br />� :i / �.. �� � .G �S �i. l.� <br />�`l �S.Z / . , � % ... i �. ": <br />,� _ , <br />li � j �. i 1.��, J.',. t! <br />U'7% ��;'��;',�.C� <br />G5/ �.E+%?.J°.? <br />Fur G��tionai Use �y Rzcording UFfice <br />NE See of Stale John.N 6ele - I1CC <br />991167641�-5 Pss <br />DOMINGO PRBLO <br />Filed: 11l08/2011 11:00 i�{1 <br />�.a�t �Aay �o� <br />�e+�lRn� <br />6�) <br />(];�,��25 /�?(�i.S <br />(:F:.►. j 2�,+ 2G1� <br />:3�%22/�iJ20 <br />�:/'�2%1�1?C� <br />�:��� �� f Jii�.. <br />�;9/:r� /2Ca� <br />;:y,%1�? i�'?_G'�'�) <br />J'3 i�C,!.i f yU:3+� <br />G�,%1���020 <br />i?b/I.a; '�02:i <br />20i108422 <br />�ia�p�id Batance <br />of Assessment <br />200�.2a <br />9286.Cv <br />3065.03 <br />3981.63 <br />3sss.�� <br />82310.40 <br />3111. 5'1. <br />2709.�2 <br />1468.00 <br />786.40 <br />Register pf Deed� <br />Hall POBOX 1692 <br />Grand Island, NE <br />This notice was p�epared and signed at ! CHICAGO, IL' <br />tne U i � `' day of November 2 G l�. <br />.. <br />, Ol'1 YRlS <br />; <br />�•�-. n rt / �n/� <br />Signature �%'l.'7-^r =7 � ,r' .lt;y iF:� ..I .�Y — V G — V V `I �r <br />f.or PAMELA J ROGERS �_.... �- -�.. ; (�����.r,•; s"�2y- 1:; :C <br />(NOTE: CerUficate of officer authorized by law to take zcic��owl��igmar.t S:, +�::i :-'��^ti�: �+% ���'� vaSi;?�tV ot i�ot's�e of Federat Tax lien • <br />•� r�ev. Rul. 71-466, 1971 - 2 C.B: 409)� .� .� � � � Farm bb@(Y)(c) (Rev. 2-2��34! <br />• � . Part 1- Kept By R��d1n� i�i�;,e - • CA7. NO 60025X • <br />"; j �r 1i233? . 63 <br />6ss�z-�.��=f <br />