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Form 668 (10 <br />04) <br />February 2004) <br />14742 <br />Department of the Treasury - Internal Revenue Service 201606290 <br />Notice of Federal Tax Lien <br />en <br />Area: <br />SMALL BUSINESS/ SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (BOO) 913 -6050 <br />Serial Number <br />228610416 <br />For Optional Use by Recording Office <br />IIK:awi■ or <br />91 6780157 <br />il d6K09/22/2016QR1M <br />s1 *� ■ aoh^ a c °�■ <br />-4 <br />:04 <br />ucc <br />Po <br />Fn <br />== 1 <br />CO <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 Tien 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 KOWALSKI FAMILY FARMS INC <br />a Corporation <br />Residence 264 A RD <br />GRAND ISLAND, NE 68801 -0314 <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 shell, <br />on the day following such date, operate as a certificate of release as defined <br />in RC 6325(a). <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refihng <br />(e) <br />Unpaid Balance <br />of Assessment <br />- (f) <br />940 <br />943 <br />12/31/2015 <br />12/31/2015 <br />1LX- XXX1105 <br />XX- XXX1105 <br />06/06/2016 <br />05/09/2016 <br />07/06/2026 <br />06/08/2026 <br />2190.91 <br />18705.53 <br />Place of Filing . <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 20896.44 <br />SeP.22. 2016 3:12FM NE `e.retary c f Stag — UCC <br />No.3066 P. 2/2 <br />This notice was prepared and signed at CHICAGO IL , on this, <br />the 08th day of September 2016 <br />Nu4 <br />for PATRICK KELLOGG <br />Signature <br />Title <br />REVENUE OFFICER <br />(3080 663 -6003 <br />24-06-3124 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment Is not essential to the validity of Notice of Federal Tex lien <br />Rev. Rul- 71 -466, 1971 - 2 C.B. 409) Form 668(Y)(c) lRev. 2 -2004) <br />Part 1 - Kept By Recording Office CAT. NO 60025X <br />