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Jul, 29, 2016 3:24FV1 NE Secretary of :State — UCC <br />Form 660 (Y)(c) <br />(Rev, February 2004) <br />Residence <br />Kind of Tax <br />(a) <br />the <br />6672 <br />6672 <br />6672 <br />6672 <br />6672 <br />Place of Filing <br />Signature <br />Tax Period <br />Ending <br />(b) <br />5216 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYI::D AREA ##4 <br />Lien Unit Phone: (300) 829 -3903 <br />Name of Taxpayer SHANNON CROSBY <br />09/30/2008 <br />12/31/2008 <br />03/31/2009 <br />06/30/2009 <br />09/30/2009 <br />This notice was prepared and signed at <br />15th day of July <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Identifying Number <br />(c) <br />XXX -XX -4476 <br />XXX -XX -4476 <br />XXX -XX -44 <br />XXX --XX - 4476 <br />XXX -XX - 4476 <br />for G.J. CARTER -LOUIS <br />2016 <br />Serial Number <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 payrnent 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 />2680 SAINT PATRICK AVE <br />GRAND 'ISLAND, NE 68803 - 1307 <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 />- - <br />— on -the- day- following-4uoh date, - operate -as a certificate -of release -as defined <br />in IRC 6325(a). <br />Date of <br />Assessment <br />(d) <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />12/14/2015 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />Part 1 - Kept By Recording Office <br />221396116 <br />Last Day for <br />Reining <br />(e) <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />01/13/2026 <br />Title <br />ACS SESE <br />(800) 829 -3903 <br />2i3 iE' 4E8 `t6 <br />For Optional Use by Recording Office <br />Sac of 54ete Jahn R Opt• <br />1 � <br />Total $ <br />(f) <br />Unpaid Balance <br />of Assessment <br />UCC FTL <br />9918777889 -4 PGE; 1 <br />CROSBY SHANNON <br />Filed: 07!2912016 09130 AM <br />10117.05 <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 />2307.18 <br />2793.14 <br />1925.84 <br />1572.58 <br />1518.31 <br />CHICAGO, IL , on this, <br />24 -00 -0008 <br />