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)(inn sae (IOW <br />(Rev_ February 2004) <br />14 5 82 AMENDMENT AMENDMENT <br />of the Treasury Internal Revenue Service 2 0 5 U z 3 <br />20150239 <br />'Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA. #4 <br />Lien Unit Phone: 000) 913 - 6050 <br />Serial Number <br />151715115 <br />For Optional Use by Recording Office <br />M/� kets JeM. P e d• UCG <br />°f 5 <br />R kis : <br />99075 <br />oalart i" ' 10t5 A ql <br />Piled. 6411 0y .5t <br />As provided by section 6321, 6322, and 6323 of the Intenwl Rcvemle <br />Code, we are giving a nodce that taxes (Including Interest and penalties <br />have been assessed against the I ng`na� taxpayer. We have made <br />s demand for payment of this liability, but it romans anpaid, Therefore, <br />there is a Oen to favor of the United States on all property and rights to <br />taxpayer , <br />property belonging to this for the a mount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer MEDBERY FABRICATION DrLC . _ <br />- <br />Residence 3230 N NORTH RD <br />GRAND ISLAND, NE 68803 -9726 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is rallied by the date given In column fel, tHis notice shall, <br />on the day following suoh date, operate as a certificate of release as defined <br />in 1RC 6326(e). <br />Kind of Tax <br />(a) <br />T E Period nding <br />mg <br />(b) <br />entifying Nuhrber <br />Identifying <br />(c) <br />Pate of <br />Assessment <br />(d) <br />Last Day for <br />Ref�Thing <br />(o) <br />of t <br />(1) <br />940 <br />941 <br />This Notice <br />on the <br />identi=fication <br />Number <br />is correct <br />12/31/2013. <br />12/31/2013 <br />of Federal <br />original 1 <br />number <br />9914744013 <br />and that <br />45- 4171490 <br />45- 4171490 <br />Tax Lien <br />recorded or. <br />124974014 <br />-2. All other <br />instrument remains <br />03/03/2014 <br />03/03/2014 <br />is filed to <br />10/29/2014, <br />recorded ab <br />information <br />in <br />04/02/2024 <br />04/02/2024 <br />correct the <br />in Hall, NE, <br />Serial Number. <br />on'the oxigjnal <br />=u11 force anc <br />280.81 <br />6833.84 <br />taxpayer's name <br />serial <br />201406876, UCC <br />notice filed <br />effect. <br />Place of Filing <br />Register of Deeds <br />. Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />, <br />$ 7114.65 <br />Apr. 17 2015 2:22PM NE Secretary of State — UCC <br />* ** AMENDMENT * ** AMENDMENT * ** AMENDMENT * ** <br />This notice was prepared and signed at CHICAGO IL , on this, <br />the 07th day of April 2015 <br />No. 0390 P. <br />g <br />Si nalture REVENUE OFFICER 24-06-2709 <br />for JAMES R VA17 (402) 473 -4677 <br />(NOTE Cerdficate of officer authorized by law to tete eetnowledgment Is not essential to Me validity of Notice of Federal Tax lien <br />Rev. Rul. 71 -4eb3. 1971 - 2 C.B. 4091 <br />Pavel - l tayt By Rem Mk Form bb8(1fr t P R s rr a O X <br />