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08/27/2012 MON 15:21 FAx 402 471 4429 UCC SECRETARY OF STATE yyy eall <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />Department of the Treasury - Internal Revenue Service � o� 2 0 �''� � <br />Notice of Federal Tax laen <br />Area: Serial Number ' <br />SMALL BUSINE3S/SELF ffiKPLOYTD AREA #4 <br />Lien Unit Phone: (800) 913-6050 888471012 <br />As provided by sec�ion 6321, 6322, and 6323 of the Intere�al Revenue <br />Code, we are giving a notfce that taxes (inttuding interest and penalties) <br />have been assessed against the following-nam� taxpayer. We have made <br />a demand for payment of this Iiability, but it remains unpaid. Therefore, <br />there is a lien in tavor of the llnited States on all propeny and rights to <br />property beloeging to tdis taxpayer for the amount of these taxes, and <br />additional penalties, interest, and coscs that may accrue. <br />WILLIS SHOE AND BOOT INC <br />a Corporation <br />Residence 379 N WALNDT ST <br />GR.AND ISLAND, NE 68801-4513 <br />For <br />Office <br />NH 3ee af Steke Jnhn N Gele - UGC F <br />9912898384-2 Pss: t <br />WILlIS SHOE RWD BOOT INC R COR <br />Filed: �8/27/2012 10:58 AM <br />�002/004 <br />IMPORTANT RELEASE INFORMA770N For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e), this notice shall. <br />on the day foliowing such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Tax Period Date of I.ast Day for <br />Kind of Tax Ending Identifying Number Assessment Refiling <br />940 �12/31/2011� 47-0821358 07/16/2012 08/15/2022 <br />llnpaid Balance <br />of Assessment <br />99.75 <br />� <br />� <br />� <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Gran Island, NE 68802-1692 <br />Totai �$ 99.75 <br />This notice was prepared and signed at CHICAGO, IL <br />the 16th day of August 2012 <br />, on this, <br />Signature ��� ' ��� OFFICER 24-10-1720 <br />> > <br />for DANIELLE L MUELLER (402) 473-4675 x2912 <br />(NOTE: Certificate of officer authorized by law to take acknowlsdgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668(n(t) (Rev. 2-2004) <br />Part 1- Kept By Recording Office CAT. NO 60025X <br />�. <br />� <br />