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0 <br />- Dec. 11. 2015 3:15PM NE Secretary of State — UCC: <br />5216 <br />Form 668 (Y)(c) <br />(Rev. February 20041 <br />Area:. Serial Number <br />SMALL BUSINESS /SELF EMPLOYED ARgA #4 1877(38115 Lien Unit Phone: (300) 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 SHANE AND WANDA SMITH ENTERPRISES <br />INC S & W PEST MANAGEMENT <br />a Corloration <br />Residence <br />I M P O R T A N T RELEASE INrORMATION: For each assessment listed below, <br />unless • - of the lien is reified by the date given in column (e), this notice shall, <br />on ollowing such date, operate as a certificate of release as defined <br />in (a). <br />Kind of Tax <br />(a) <br />941 <br />941 <br />941 <br />Tax Period <br />Ending <br />(b) <br />Place of Fiting <br />th e <br />PO BOX 1294 <br />GRAND ISLAND, NE 68802 -1294 <br />06 30 20 ' <br />09/30/2014 <br />12/31/2014 <br />This notice was prepared and signed at <br />o .. o.,i 71-a6F 1071 2 C.B. 409) <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal . Tax Lien <br />Identifying Number <br />XX -XXXI i3 b ai <br />XX- XXX1868 <br />XX- XXX1868 <br />25th day of November 2015 <br />- <br />Date of <br />Assessment <br />(d) <br />U2/16/2015 <br />03/09/2015 <br />05/18/2015 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 - 1692 <br />CHICAGO, IL <br />Last Day for <br />Refing <br />(e) <br />04/08/2025 <br />06/17/2025 <br />For Optional Use by Recording Office <br />NE 5eE of 51a4a doh,+ A Gale UGC GTL <br />I I <br />1 <br />9915705126 —a pea; 1 <br />SHANE AND WANDA SMITH ENTERPRI <br />Filed: 12/11/2015 01:26 PSI <br />Total <br />No. 4038 P. 2;'2 <br />20150€ 2 <br />Unpaid Balance <br />of Assessment <br />(f) <br />8497 07 <br />7064.97 <br />174.04 <br />$ 15736.08 <br />on this, <br />Signature es,,, bitxr . " Title <br />REVENUE OFFICER . 24 -06 -2744 <br />for J KELLOGG <br />(308) 663 -6003 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Form 668(Y)(c) (Bev. 2 -2004) <br />