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08/07/2012 TUE 12:55 FAX 4p2 471 4429 UCC SECitETARY OF STATE ~~~ Hall <br />N6 &ea of Bisie John A Ciale - UCC F7L <br />9932686979-3 Pes; 1 <br />TOTAL SERVICES INC 72-27-94 R <br />Filed: t�e107/2012 09:03 AM <br />�orm 668 (Y)(c) <br />(Rev. Febroary 2004) <br />Department of the Treasury - Internal Revenue Service <br />Notice o� Federal Tax Lien <br />Area: Serial Mumber <br />SMALL BIISINESS/SELF FMPLOYBD ARFA #4 <br />Lien Unit Phone: (800) 913-6050 884291012 <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a not�ce that taxes (including interest and penalties) <br />have been assessed against the followmg-named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a tien in favar cf the linited States on afl property and r7g6ts to <br />propeny belongiag to this taxpayer for t6e amoant of these taxa, and <br />8dditio�tal pe�llties interest, and costs that may accrue. <br />axpayer <br />a Corporation <br />��o <br />Residence 511 P CAPTTAL AVE <br />GRAND ISLAND, NP 68801-2413 <br />IMPORTANT RELF.ASE INFORMATION For each assessmant listed below, <br />unless notice of the lien is refiled by the date give� in column (e), this notice shall, <br />on the day following such date, operate as a certificate ofi release as defined <br />in IRC 6325(a). <br />Tax Period Date of last D_ay for <br />Kind of Tax Ending Identifping Wumber Assessment � Rehling <br />940 12/31/2010 4?-0784222 06/13/2011 07/13/2021 <br />941 03/31/2011 47-07842�2 07/02/2012 08/O1/2022 <br />941 09/30j2011 47-Q784222 07/02/2012 08/O1/2022 <br />Place of Filing <br />Register of Deeds <br />Hal1 POBOX 1692 <br />Grand Island, NE 68802-1692 <br />�ooz�ooa <br />47.69 <br />g94.23 <br />474.32 <br />Total I $ 1016 . 24 <br />This notice was prepared and signed at CHICAGO, IL <br />the 26th day of July 2012 <br />. <br />, on this, <br />Signature �'��-� C�� <br />� � <br />for PATRICK J KELLOGG <br />Title <br />�E OFFICER <br />(308) 384-4850 <br />24-10-1744 ' <br />(NOTE: Certificate of officer authorized by lauv to take acknowledgment is not essential to the validity of NoNca of Federal Tax lisn , <br />Rev. Rul. 71-466, 1971 - Z C.B. 409) Form 668(Y)(c) (Rev. 2-2004) <br />Part 1^ Kept By Recording Offfce CAT. NO 60025X ' <br />For O�ttonal Use bv Recordinq Qffice <br />2012Q65�5 <br />llnpaid Balance <br />of Assessment <br />