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Form 668 (Y)(c) <br />(Rev. February 2004) <br />5216 Department 201601421 <br />artment of the Treasury Internal Revenue Service <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 />200817216 <br />For Optional Use by Recording Office <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 />Nit See of st.{ John a Gals - Il[[ FTL <br />have been assessed against the following -named taxpayer. We have made <br />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 />9916769961-4 <br />Pas; <br />Name of Taxpayer ROSES FOR YOU, a Partnership <br />ROSES FOR YOU, R PARTNERSHIP <br />Filed: 03/09/2016 12:37 PM <br />ZNAMENACEK ANDREW S GEN PTR <br />Residence 937 S LOCUST ST <br />GRAND ISLAND, NE 68801 -6751 <br />IMPORTANT RELEASE' INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (a), 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 dumber <br />Assessment <br />Refi ling <br />of Assessment <br />(a) <br />(i <br />(d) <br />(e) <br />(f) <br />941 <br />06/30 <br />M fin M 1' 1 l`1 rf) rr) M M M <br />NNNNfVNNNCVN <br />I• N L -N <br />• <br />1 � �1j X 11 1j �1j ry11 11'] 1 � <br />06/23/2014 <br />07/23/2024 <br />1744.62 <br />941. <br />03/31 <br />01/04/2016 <br />02/03/2026 <br />2882.14 <br />941 <br />06/30 <br />01/04/2016 <br />02/03/2026 <br />2572.12 <br />941 <br />09/30 <br />01/04/2016 <br />02/03/2026 <br />3259.36 <br />941 <br />12/31 <br />01/04/2016 <br />02/03/2026 <br />3108.78 <br />941 <br />06/30 <br />01/04/2016 <br />02/03/2026 <br />3829.69 <br />941 <br />09/30 <br />05/25/2015 <br />06/24/2025 <br />2553.70 <br />941 <br />12/31 <br />01/04/2016 <br />02/03/2026 <br />2081.63 <br />941 <br />03/31 <br />01/04/2016 <br />02/03/2026 <br />2579.94 <br />941 <br />06/30 <br />01/04/2016 <br />02/03/2026 <br />2279.71 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 26891.69 <br />Grand Island, NE 68802 -1692 <br />Vlar, 9. 2016 4:21PM NE Secretary of State — UCC <br />No. 5457 F. <br />This notice wes prepared and signed at CHICAGO, IL <br />on this, <br />the <br />26th. day of February 2016 <br />Signature <br />for PATRICK J KELLOGG <br />Title <br />REVENUE OFFICER 24 -06 -2744 <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 />Rev. Rul. 71 -466, 1971 - 2 C.B. 409) <br />Part 1 - Kept By Recording Office <br />Form 666(Y)(c) (Rev. 2 -2004) <br />CAT. NO 60025X <br />