B10 (Official Form 10) (04/10)

10-12240-hcm Claim#4-1 Filed 08/31/10 Main Document Page 1 of 4

DISTRICT OF TEXAS PROOF OF CLAIM

UNITED STATES BANKRUPTCY COURT WESTERN

Case Number: Name of Debtor: 10-12240-CAG MICHAEL J. COKER NOTE: This form should not be used to make a claim for an administrative expense arising after the commencement of the case. A request of payment of an administrative expense may be filed pursuant to 11 U.S.C. 503. Name of Creditor (The person or other entity to whom the debtor owes money or property): Check this box to indicate that this Department of the Treasury - Internal Revenue Service claim amends a previously filed claim. Name and address where notices should be sent: Internal Revenue Service Court Claim Number: P.O. Box 21126 (If known) Philadelphia, PA 19114 Filed on: Telephone number: 1-800-913-9358 Creditor Number: 14620572 Check this box if you are aware that anyone else has filed a proof of claim relating to your claim. Attach copy of statement giving particulars. Check this box if you are the debtor or trustee in this case. $ 170,819.29 Name and address where payments should be sent (if different from above): Internal Revenue Service 300 E 8TH STREET M/S 5026 AUS AUSTIN, TX 78701 Telephone Number: (512) 499-5240 1. Amount of Claim as of Date Case Filed:

5. Amount of Claim Entitled to Priority under 11 U.S.C. 507(a). If If all or part of your claim is secured, complete item 4 below; however, if all of your claim is unsecured, do not complete any portion of your claim falls in item 4. one of the following categories, check the box and state the If all or part of your claim is entitled to priority, complete item 5. amount. Check this box if claim includes interest or other charges in addition to the principal amount of claim. Attach itemized statement of interest or charges. Specify the priority of the claim. Domestic support obligations under 11 U.S.C. 507(a)(1)(A) or (a)(1)(B). See Attachment Wages, salaries, or commissions (up to $11,725*) earned within 180 days before filing of the bankruptcy petition or cessation of the debtor's business, whichever is earlier - 11 U.S.C. 507 (a)(4). Contributions to an employee benefit plan -11 U.S.C. 507 (a)(5). Up to $2,600* of deposits toward purchase, lease, or rental of property or services for personal, family, or household use - 11 U.S.C. 507 (a)(7). Taxes or penalties owed to governmental units - 11 U.S.C. 507 (a)(8). Other - Specify applicable paragraph of 11 U.S.C. 507 (a)(__). Amount entitled to priority: $ *Amounts are subject to adjustment on 4/1/13 and every 3 years thereafter with respect to cases commenced on or after the date of adjustment.
FOR COURT USE ONLY

2. Basis for Claim: Taxes (See instruction #2 on reverse side.) 3. Last four digits of any number by which creditor identifies debtor:

3a. Debtor may have scheduled account as: (See instruction #3a on reverse side.) 4. Secured Claim (See instruction #4 on reverse side.) Check the appropriate box if your claim is secured by a lien on property or a right of setoff and provide the requested information. Nature of property or right of setoff: Real Estate Motor Vehicle Describe: *All of debtor(s) right, title and interest to property - 26 U.S.C. 6321 Value of Property:$________________ Annual Interest Rate 4 % Amount of arrearage and other charges as of time case filed included in secured claim, if any: $ 170,819.29 Amount of Secured Claim: $ 170,819.29 Basis for perfection: See Attachment Other

Amount Unsecured: $

6. Credits: The amount of all payments on this claim has been credited for the purpose of making this proof of claim. 7. Documents: Attach redacted copies of any documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements or running accounts, contracts, judgments, mortgages, and security agreements. You may also attach a summary. Attach redacted copies of documents providing evidence of perfection of a security interest. You may also attach a summary. (See instruction 7 and definition of "redacted" on reverse side.) DO NOT SEND ORIGINAL DOCUMENTS. ATTACHED DOCUMENTS MAY BE DESTROYED AFTER SCANNING. If the documents are not available, please explain:

Date:

08/30/2010

Signature: The person filing this claim must sign it. Sign and print name and title, if any, of the creditor or other person authorized to file this claim and state address and telephone number if different from the notice address above. Attach copy of power of attorney, if any. Internal Revenue Service 300 E 8TH STREET M/S 5026 AUS AUSTIN, TX 78701

/s/ KERI TEMPLETON, Bankruptcy Specialist (512) 499-5240

Penalty for presenting fraudulent claim: Fine of up to $500,000 or imprisonment for up to 5 years, or both. 18 U.S.C 152 and 3571.

10-12240-hcm Claim#4-1 Filed 08/31/10 Main Document Page 2 of 4

Proof of Claim for Internal Revenue Taxes

Department of the Treasury/Internal Revenue Service In the Matter of: MICHAEL J. COKER ONE LONGHORN DRIVE ROUND ROCK, TX 78681

Form

10

Attachment Case Number 10-12240-CAG Type of Bankruptcy Case CHAPTER 11 Date of Petition 08/09/2010

The United States has the right of setoff or counterclaim(s) in the amount of $5,563.00. The identification of the right of setoff in the amount is based on available data and is not intended to waive or limit the right to setoff against this claim debts owed to this debtor by this or any other federal agency that have not been identified. All rights of setoff are preserved and will be asserted to the extent lawful. Secured Claims
Taxpayer ID Number XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 (Notices of Federal tax lien filed under internal revenue laws before petition date) Tax Period 06/30/2001 09/30/2001 12/31/2001 12/31/2001 03/31/2002 06/30/2002 09/30/2002 12/31/2002 12/31/2002 03/31/2003 Date Tax Assessed 12/27/2004 12/27/2004 08/30/2004 12/27/2004 12/27/2004 12/27/2004 12/27/2004 12/20/2004 12/27/2004 12/27/2004 Tax Due $9,102.20 $28,779.10 $3,674.38 $41,263.78 $9,827.74 $5,282.30 $1,073.48 $7,882.00 $3,630.67 $3,290.69 $113,806.34 Penalty to Petition Date $0.00 $0.00 $3,153.26 $0.00 $0.00 $0.00 $0.00 $5,486.51 $0.00 $0.00 $8,639.77 Interest to Petition Date Notice of Tax Lien Filed: Date Office Location TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY TRAVIS COUNTY

Kind of Tax CIVIL PEN CIVIL PEN INCOME CIVIL PEN CIVIL PEN CIVIL PEN CIVIL PEN INCOME CIVIL PEN CIVIL PEN

$3,714.94 05/19/2005 $11,745.88 05/19/2005 $2,529.02 06/01/2005 $16,841.41 05/19/2005 $4,011.08 05/19/2005 $2,155.94 05/19/2005 $438.15 05/19/2005 $4,111.87 05/19/2005 $1,481.83 05/19/2005 $1,343.06 05/19/2005 $48,373.18

Total Amount of Secured Claims:

$170,819.29

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10-12240-hcm Claim#4-1 Filed 08/31/10 Main Document Page 3 of 4

1872 INTERNAL REVENUE SERVICE FACSIMILE FEDERAL TAX LIEN DOCUMENT BANKRUPTCY DOCKET: 10-12240-CAG
Area: SMALL BUSINESS/SELF EMPLOYED #5 Lien Unit Phone: (800) 913-6050

COURT RECORDING DATA Lien Recorded : 05/19/2005 - 14:29PM Recording Number: 2005088243 UCC Number : Liber : Page :
IRS Serial Number: 225867005

This Lien Has Been Filed in Accordance with Internal Revenue Regulation 301.6323(f)-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 column(e), this notice shall constitute the certificate of release of lien as defined in IRC 6325(a).
Form (a) 6672 6672 6672 6672 6672 6672 1040 6672 6672 Period (b) 06/30/2001 09/30/2001 12/31/2001 03/31/2002 06/30/2002 09/30/2002 12/31/2002 12/31/2002 03/31/2003 ID Number (c) XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 XXX-XX-2537 Assessed (d) 12/27/2004 12/27/2004 12/27/2004 12/27/2004 12/27/2004 12/27/2004 12/20/2004 12/27/2004 12/27/2004 Refile Deadline (e) 01/26/2015 01/26/2015 01/26/2015 01/26/2015 01/26/2015 01/26/2015 01/19/2015 01/26/2015 01/26/2015 Unpaid Balance (f) $9,102.20 $28,779.10 $41,263.78 $9,827.74 $5,282.30 $1,073.48 $11,483.88 $3,630.67 $3,290.69

Filed at: TRAVIS COUNTY AUSTIN, TX 78767 This notice was prepared and executed at NASHVILLE, TN on this, the 29th day of April, 2005. Authorizing Official: M. WOODARD Title: REVENUE OFFICER 30-15-2245 Total $113,733.84

10-12240-hcm Claim#4-1 Filed 08/31/10 Main Document Page 4 of 4

1872 INTERNAL REVENUE SERVICE FACSIMILE FEDERAL TAX LIEN DOCUMENT BANKRUPTCY DOCKET: 10-12240-CAG
Area: SMALL BUSINESS/SELF EMPLOYED #5 Lien Unit Phone: (800) 913-6050

COURT RECORDING DATA Lien Recorded : 06/01/2005 - 13:20PM Recording Number: 2005095812 UCC Number : Liber : Page :
IRS Serial Number: 228472505

This Lien Has Been Filed in Accordance with Internal Revenue Regulation 301.6323(f)-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 column(e), this notice shall constitute the certificate of release of lien as defined in IRC 6325(a).
Form (a) 1040 Period (b) 12/31/2001 ID Number (c) XXX-XX-2537 Assessed (d) 08/30/2004 Refile Deadline (e) 09/29/2014 Unpaid Balance (f) $7,268.12

Filed at: TRAVIS COUNTY AUSTIN, TX 78767 This notice was prepared and executed at NASHVILLE, TN on this, the 17th day of May, 2005. Authorizing Official: M. WOODARD Title: REVENUE OFFICER 30-15-2245 Total $7,268.12