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Jul.14. 2015 2:45FM NE Secretary of State — UCC <br />Form 668 (Y)(c) <br />(Rev_ February 2004) <br />Area: <br />SMALL BUTSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 - 6050 <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 GIGGLES INC, a Corporation <br />Residence <br />Kind of Tax <br />(a) <br />1120 <br />940 <br />941 <br />941 <br />941 <br />Place of Filing <br />the <br />Signature <br />11290 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <br />1409 N WEBB RD <br />GRAND ISLAND, NE 68803 -2313 <br />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 />Tax Period <br />Ending <br />(b) <br />1 2/ 3 1/ 2 01 3 <br />1 <br />12/31/2013 <br />06/30/2014 <br />09/30/2014 <br />30th day of June <br />Identifying Number <br />(c) <br />t140, e <br />for PATRICK a KELLOGG <br />XX- XXX8886 <br />XX XXX8886 <br />XX- XXX8886 <br />XX- XXX8886 <br />XX- XXX8886 <br />2015 <br />Date of <br />Assessment <br />05/11/2015 <br />05/25/2015 <br />06/15/2015 <br />06/08/2015 <br />06/08/2015 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 - 1692 <br />Part 1 - Kept By Recording Office <br />164470015 <br />Last Day for <br />Ref ling <br />('e) <br />06/10/2025 <br />06/24/2025 <br />07/15/2025 <br />07/08/2025 <br />07/08/2025 <br />Title <br />REVENUE OFFICER <br />(308) 663 - 6003 <br />Total $ <br />N0,1781 F. 12 <br />201504769 <br />For Optional Use by Recording Office <br />Nu Cee of Slate Jvhn A a+le - UCC FT <br />9915757696 -5 Pgs: <br />GIGGLES INC R CORPORATION <br />Filed: 07/14/2015 11:20 All <br />Unpaid Balance <br />of Assessment <br />(r) <br />2730.00 <br />- 823.08 <br />11300.81 <br />16446.66 <br />24081.02 <br />55381,57 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />24 -06 -2744 <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.S. 4091 Form 669(Y)(c) (Rev. 2 -2004) <br />CAT. NO 60025X <br />