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Form 668 (Y)(c) <br />(Rev. February 2004) <br />11290 <br />Department of the Treasury - Internal Revenue Service 0 0 r , r►� <br />cc <br />2 U 1 b U 4 10 <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 />160305315 <br />For Optional Use by Recording Office <br />5 }a}a John E 661e - UGC GM <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />NE <br />Sec of <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 />1 <br />991575 ®229 -5 CORPORA <br />F 06(119I2015� <br />Name of Taxpayer CREATIVE CORNER INC, a Corporation <br />Residence 115 W CHARLES ST <br />GRAND ISLAND, NE 68801 -6020 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is railed 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 />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(1 ) <br />(c) <br />(d) <br />(e) <br />(0 <br />09/30 <br />a1�o� 01 rnm01 rnmrnsma101 <br />rn.rn�mrnrn mm <br />d dt dc di di dr cif dt dr'di <br />03 03 mCO 13 CO 03 co CD CO CO CO 03 m <br />ri,1„L,„„t„ <br />000000000000000 <br />12/22/2014 <br />01/21/2025 <br />10566.05 <br />12/31 <br />12/22/2014 <br />01/21/2025 <br />13903.57 <br />03/31 <br />12/15/2014 <br />01/14/2025 <br />16419.68 <br />06/30 <br />12/22/2014 <br />01/21/2025 <br />12845.28 <br />09/30 <br />12/22/2014 <br />01/21 /2025 <br />14799.90 <br />12/31 <br />12/15/2014 <br />01/14/2025 <br />17317.63 <br />03/31 <br />12/15/2014 <br />01/14/2025 <br />17584.34 <br />06/30 <br />12/15/2014 <br />01/14/2025 <br />15371.13 <br />Tri <br />09/30 <br />12/15/2014 <br />01/14/2025 <br />18011.46 <br />12/31 <br />12/15/2014 <br />01/14/2025 <br />14326.93 <br />03/31 <br />12/22/2014 <br />01/21/2025 <br />16520.33 <br />06/3 <br />12/15/2014 <br />01/14/2025 <br />14638.61 <br />09/30 <br />12/15/2014 <br />01/14/2025 <br />15209.90 <br />12/31/2007 <br />12/15/2014 <br />01/14/2025 <br />10714.23 <br />03/31/2008 <br />12/22/2014 <br />01/21/2025 <br />5190.13 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 213 419.17 <br />Grand Island, NE 68802 <br />Jun. 13. 261: 3: FM NE Secretary of State — UCC <br />This notice was prepared and signed at <br />the <br />03rd day of June 2015 <br />e <br />for DANIELLE L MUELLER <br />Signature <br />CHICAGO, IL <br />Part 1 - Kept Sy Recording Office <br />Title <br />REVENUE OFFICER <br />(402) 473 -4675 <br />NL. 1363 F. J:' J <br />, on this, <br />24-06 -2720 <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. Rul. 71 -466, 1971 2 C.B. 409) <br />Form 668(Y)(c) (Rev. 2 - 2004) <br />CAT. NO 60025X <br />