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Form 668 (Y)(c) <br />(Rev. February 20041 <br />3595 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />923589113 <br />For Optional Use by Recording Office <br />NE See of Siaie John R Gale - UCC FTL <br />9913709865 -2 Pgs: t <br />MID - AMERICA TRANSFER INCA COR <br />Filed: 0 3/04!2013 01:35 PM <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (including interest and penalties) <br />have been assessed against the following -named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a lien in favor of the United States on all property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer MID- AMERICA TRANSFER INC <br />a Corporation <br />Residence PO BOX 1767 <br />GRAND ISLAND, NE 68802 -1767 <br />I IMPORTANT RELEASE INFORMATION: 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 following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day <br />Refilling <br />(e) <br />for <br />Unpaid Balance <br />of Assessment <br />(1) <br />941 <br />09/30/2012 <br />20- 2557800 <br />01/07/2013 <br />02/06/2023 <br />5538.58 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 5538.58 <br />03/04/2013 MON 14:12 FAX 402 471 4429 UCC SECRETARY OF STATE <br />This notice was prepared and signed at <br />the <br />Signature <br />20th day of February 2013 <br />for PATRICK J KELLOGG <br />yNy <br />Title <br />REVENUE OFFICER <br />(308) 384 -4850 <br />Hall <br />201301709 <br />CHICAGO, IL , on this, <br />24 -10 -1744 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev. Rut. 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) (Rev. 2 -2004) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />0002 /006 <br />