10 otra Form 1 olQai!2240-hom Claim#4-1 Filed 08/31/10 Main Document Page 1 of 4 UNITED STATES BANKRUPTCY COURT WESTERN DISTRICT OF TEXAS. PROOF OF CLAIM. Namal bar MICHAEL J. COKER [Ce Neaer Tos240.CAG. NOTE Tis or sew na he wel ty maa a fora Aa pane Os Oe COREA Tate A eee RT a niirsiatve expense ay heed pura to USC. 6303 Tans of Cron (The person or tr cy fo whom the dbior owes mney or prope) ‘Department of the Tau - Intra Revense Service ‘Nuns and adress were nos sould bes Intenl Revenue Service PO. Rox 21126 Patni, PA 19116 “Telephone number 18009139398 rst Nambe= 14620572 TB Check is box wind a «lain amends a previous fied Court Cain Numbers es) ‘Name aed adress where pines sould bs Sent FAAS om ADV Tate Revenue Service nag EET STREET Missi26aus AUSTIN, TX 78701 elephone Number (512) 499-5240 T Gece fox you ave aware Dae snyone ele hs ie poo of lain ‘eltingtoryou claim. tact copy of ‘Sateen hcg parla 1D Check this box ity ae te debtor ors i hi ease T. Amount of Claim as of Date Cane Fede FED = alle pas of your aim is eee comple tem 4 below; however, fl of your em is mse do ot comple item alle par of your claim i ented priority, complete eS 1 Check this box i lai icles irs or oter charges i adtion 6 he principal amoust of ain. ach emized statment fire: charges, Iz Areowac of Clan Fasiea vo Priority wader U1 US.C. $8074). I ‘any pores of your tan falls ‘ove ofthe fellomtng eategories, hock the box and tate the Speci te proity oF he lai, Domestic sipor obligations unr Rai or Can Tae (Sse inststion 1 0 OVERSEE) TUS. §80%aK1 A} oF (BD Tas oar digs of any umber by wilh ever Meaies debian Sos Aen 3a, Debtor may have setedued account {Se insur a on reverse side) 1 Wages slay, or commissions up tw $11,235") eave within 180 days before lag afte barup ey Penn or esaton of the des “Secured Clan (Sec istction # 9n reverse side) (Check he appropriate tox if your clan sous hy ain om prope ora ag of sa al wove the requested iron. Nature of property or right of sett: Real Pstate A Motor Vebste mother Deserves 24 of debiors) righ and eres propert)-26 USC. 66821 Vale of Property Annual Interest Rate 4% Amount of arrearage abd oer charges as af tie case ied nei in sesared lain any: S170 819.29 sis for porfeet See Avachoent Amount of Secured Claim: § 17051929 Amount Unsure Prince, whichever eater USC $507 ne 5 Contos tan splays echt plas! US.C.§307 GS) Up 49 $2,600" depois oar ech ue ort of apy [rserics for personal, fat ox owecholl te 11 USC. BMT aK “Taxes opens ea Eovsromenial unis 11 USC. $807 (as Cradle The aa of a pagans is Sa a Bo ead To Uap ang spat a a 7-Documente: Asch reactod caps of any documents st sappot he cam such promissory kes, purchass ender, invnces, eine snemets or mang cco cena jadpmen'oegapes ad SSS Herenmeatc You ay ls stich asumnmary. Atach edad copis of documents proving evidence of Defocton ofa acount erst. You may als ata a sumnay (See ouructon 7 and fio of react” on revere sie) DO NOT SEND ORIGINAL DOCUMENTS. ATTACHED DOCUMENTS MAY BE DESTROYED AFTER SCANNING: (Other Specify applicable paragraph ehHUSC.§507 Gk) Anon ponty 8 mount are sect aust on 13 an every boars these with spc oases commenced ono ter ie dace of ausumen Ie docunente ae no aval, lease epi: TSipatare: Ti para ling it Gam aust ga Spm pan nae mad We, Tang OFS Date: 05302010 cet oor person auosi2 to ets claim and state ares and lone amber if _ “fre! rom the notice aes abons- Aah cy af pero tomes, Han. |AUKER) TEMPLETON, Invemal ewenueSevice Bankrupiey Specialist, SODESTH STREET (S13) 495240 uss026 AUS. AUSTIN, TX 7870) FOR COURT UST ONTY “Fea Fr prenis FaeaTo abe Fibs SE po SOTO oF PATO TH op WS Fea eT TORCH aad Tr~10.42240-hem Claimiid.1 Filed 08/21/10 Main Document Page? af 4 Proof of Claim for Form 10 _ Internal Revenue Taxes Machen Department of the Treasury/Internal Revenue Service In the Matter of: MICHAEL J. COKER ‘Case Number 10-12240-CAG ONE LONGHORN DRIVE Type of Bankruptey Case ROUND ROCK, TX 78681 CHAPTER IL Di tition 08/09/2010 erclain(s) in the amount of $3,563.00. The identification of the right of seoIT in the amount is based on available data and is not intended to waive or limit the right to setofT against this elaim debis owed to this debtor by this orany other federal agency that have not been identified. All rights of setoff are preserved and will be asserted to the extent lawful ‘Secured Claims (Nouser of Fra Ten ed ons vein even lv boos evan ae) 7% Dae Tax Penal io XXXXX2S7 CIVILPEN 6902001 122772004 sooo S371494 051192008 TRAVIS COUNTY XXXXX2597CIVILPEN 09802001. 12272004 so S174588 @S)L02015. TRAVIS COUNTY XXX-XX-2807 INCOME buo1oxo00 sa isa.6 2.52962 QWOLINIS TRAVIS COUNTY XXX-AX2S7 CIVILPEN 2001 127272008, $000 $16,341) OS/9R00§ TRAVIS COUNTY XXXXX-2597 CIVILPEN —o¥T1/2002. 127272004 si00 SA 0108 51192005 TRAVIS COUNTY CIVILPEN 06102002 127272004 $2155.94 €5292005 TRAVIS COUNTY CIVILPEN 07302002 137272008 s.07ae S43815 @819R005 TRAVIS COUNTY INCOME 12613002 122071004 1982.00 esi9200s “TRAVIS COUNTY NOOXX2S7 CIVILPEN 120172002 1227/2008 s606 USI192MS TRAVIS COUNTY 6 S9200S TRAVIS COUNTY Bae aa SRN nS: $170,819.29 Total Amount of Secured Clai Page 1 of |10-12240-hem Claim#4-1 Filed 08/31/10 Main Document Page 3 of 4 1872 COURT RECORDING DATA INTERNAL REVENUE SERVICE FACSIMILE FEDERAL TAX LIEN Document [Recording Number: 2005088243 BANKRUPTCY DOCKET: 10-12240-CAG Lien Recorded : 05/19/2005 - ucc Number : biber Page 14:29PM Area: SMALL BUSINESS/SBLF EMPLOYED #5 Lien Unit Phone: (800) 913-6050 ras Serial Number: 225867005 This Lien Has Been Filed in Accordance with Internal Revenue Regi tion 301.6323 (2) -1 Name of Taxpayer: MICHAEL J COKER Residence: 7301 RR 620 N STE 155 131 AUSTIN, TX 78726-0000 With respect to each assessment below, unless notice of lien is refiled by the date in colum/(e], this notice shall constitute the certificate of release of lien 4s defined in IRC 6325(a). Form Period TD Number Recessed Refile besdline Unpaid Balance (a) (») () @ © te) 672 06/30/2001 HKK-KR-2537 12/27/2004 i726 70) $3,102.20 6672 09/30/2001 XXX-XK-2537 12/27/2004 02/26/2015 $28,778.10 6672 12/31/2001 XXX-xx-2527 12/27/2004 02/26/2015 $41,263.78 6672 03/31/2002 XXX-XX-2537 12/27/2004 01/26/2015 $9,827.74 6672 06/30/2002 XXX-AX-2527 12/27/2004 02/26/2015 $5,282.30 6672 09/30/2002 XXX-Xx-2537 12/27/2004 91/26/2015 $1,073.48 1040 12/31/2002 XXX-XX-2537 12/20/2004 01/19/2015 sit,483.e8 6672 12/31/2002 XXX-xx-2537 12/27/2004 02/26/2015 53,630.67 6672 03/31/2003 XXX-XX-2537 12/27/2008 01/26 53,290.69 Filed at: | TRAVIS COUNTY Total $113,733.84 AUSTIN, TK 78767 This notice was prepared and executed at NASHVILLE, TN on this, the 29th day of April, 2005 huthorizing Official: Titie, M. WOODARD REVENUR OFFICER 30-15-22451872, INTERNAL REVENUS SERVICE ACSI BANKRUPTCY DOCKET: Area! Name of Taxpayer: WICHAEL J COKER Residence: TLE FEDERAL TAX 10-12240-CaG SMALL BUSINESS/SELF EMPLOYED #5 Tien Unit Phone: (800) 9: 913-6050 This Lien Has Been Filed in Accordance with Internal Revenue Regulation 301.6323 (£)-1. 7301 RR 620 N STS 155 131 AUSTIN, TX 78726-0000 With respect to each asseserent below, is refiled by the date in columie), the certificate of release of lien as defined in IRC 6325(a). EEN DOCUMENT Page Lien Recorded Recording Number: 2005095812 ucc Number Liber fiks Serial Number 10-12240-hem Claim#4-1 Filed 08/31/10 Main Document Page 4 of 4 COURT RECORDING DATA unless notice of lien this notice shall constitute 228472505 + 06/01/2005 - 13:20PM Form Period TD wumber Raseaaed Refile Deadline Unpaid Balance @ (by ) @ ) fe) 3040 2/31/2001 -XXK-KK-2537 08/30/2008 05/25/a014 57,268.12 Filed at: TRAVIS COUNTY $7,268.12 AUSTIN, TX 78767 This notice was prepared and executed at NASHVILLE, TW on this, the 17th day of May, 2005. Authorizing Official M. WOODARD Title: REVENUE OFFICER 30-15-2245