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Area: <br />SMALL BUSINESS/ SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (000) 913 - 6050 <br />As provided by secdon 6321, 6322, and 6323 of the Internal Revenue <br />'ode, we are giving a notice that taxes (including interim and penalties) <br />have been assessed against the following-named taxpayer. We have made <br />a demand for payment of this liability, but ft. remains unpaid. Therefore, <br />there is a Tien 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 penaides, interest, and costs that may accrue- <br />Name of Taxpayer WILLIS SHOE AND BOOT INC <br />a Corporation <br />Residence <br />Kind of Tax <br />(a) <br />941 <br />941 <br />941 <br />Place of Filing <br />This notice was prepared and signed at CHICAGO T IL , on this, <br />the <br />Jan,22 2414 2:33PM NE Secretary of State — UCC 2 0 1 40 03 0,5973 P. 2!3 <br />379 N WALNCI ' ST <br />GRAND ISLAND, NE 68801 -4513 <br />I MPORTANT RELEASE INFORMATION: For each assessment listed below, <br />u nless notice of the lien is refiled by the date given in column (e). this notice shall, <br />o n the day following such date, operate as a certificate of release as defined <br />in IBC 6325(a). <br />Tax Period Ending <br />03/31/2013 <br />06/30/2013 <br />09/30/2013 <br />oath day of January 2014 <br />Department of the Treasury - internal Revenue Service <br />Notice of Federal Tax Lien <br />Idendfyhtg Number <br />(c) <br />47- 0821358 <br />47- 0821358 <br />47- 0827.358 <br />Serial Number <br />Date of <br />Assessment <br />(d) <br />12/23/2013 <br />12/23/2013 <br />12/23/2013 <br />Register of Deeds <br />Hall POSO1t 1692 <br />Grand Island, NE 68802 -1692 <br />977431014 <br />Last Day for <br />RelilAogg <br />(e) <br />01/22/2024 <br />01/22/2024 <br />01/22/2024 <br />r RLVSNUE OFFICER <br />(402) 473 -4675 x2912 <br />For Optional Use by Reoarding Office <br />N! Sao of State John A Gala - UCC FTL <br />NO INIIII [ U <br />9914729378 -9 P9a: 1 <br />WILLIE SHOE RPD BOOT INC A COR <br />Filed! 011221zef4 19:61 RIl <br />Total $ <br />Unpaid Balance <br />of Assessment <br />('1 <br />8612.96 <br />6398 -12 <br />4723.78 <br />19734.88 <br />Signature <br />for DANIELLE L MUELLERF� MUELLER <br />(NOT6r Certificate of officer authorized by law to take acknowledgment Is not essential to the validity or Notice of Federal Tex yen <br />Rev. Rut, 71 -468, 1971 - 2 C.B. 409) <br />24 - 10 - 1720\ <br />Form 668(1()([) (Rev. 2 -20041 <br />Part 1 • I.epc By to rnT NO enn9av <br />