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2ep,30. 2015 2:44FM NE Secretary of State — UCC <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (90o) 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 thls 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 />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 />941 <br />Place of Filing <br />Signature <br />1409 N WEBB RD <br />GRAND ISLAND, NE 68803 -2313 <br />Tax Period <br />Ending <br />(b) <br />5216 <br />1 2/31/20 14 <br />This notice was prepared and signed at <br />for PATRICK J KELLOGG <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Identifying Number <br />(c) <br />XX- XXX8886 <br />Serial Number <br />Date of <br />Assessment <br />(d) <br />07 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand island, NE 68802 -1692 <br />the 11th day of September 2015 <br />176012315 <br />Last Day for <br />Refilling <br />(e) <br />08/12/2025 <br />Title <br />REVENUE OFFICER <br />(308) 663 -6003 <br />Total $ <br />2930 F. <br />For Optional Use by Recording Office <br />NG lac .f 5 ate Jahn A - UCC [TL <br />1111 11 <br />9915761607 -4 Pas: <br />GIGGLES INC A CORPORATION <br />Filed: 09/5.l2015 01:36 PM <br />201506707 <br />Unpaid Balance <br />of Assessment <br />(f) <br />21950.98 <br />21950.98 <br />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 />Rsv. Rul. 71 -466. 1971 - 2 C.B_ 4091 <br />