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Mar. 29. 2017 3:37FM 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: (800) 913 -6050 <br />Residence <br />Kind of Tax <br />(a) <br />941 <br />Place of Filing <br />the <br />104 E 6TH ST <br />WOOD RIVER, NE 68883 <br />Tax Period <br />Ending <br />(b) <br />11874 <br />09/30/2016 <br />This notice was prepared and signed at <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Identifying Number <br />(c) <br />XX- XXX8025 <br />13th d of March 2017 <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 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 TOURNEY BROTHERS METAL FABRICATION <br />I IMPORTANT RELEASE INFORMATION: For each assessment fisted 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 1RC 8325(a). <br />Date of <br />Assessment <br />(d) <br />0 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />CHICAGO, IL <br />252541917 <br />Last Day for <br />Refilzng <br />(e) <br />03/08/2027 <br />Nc.0222 F. 4/5 <br />2 017'01939 <br />For Optional Use by Recording Office <br />NE Sec of slot. John a Gale - NCt GTL <br />11111 11111 <br />9917789482 -2 Pgs: 1 <br />TOURNEY BROTHERS METAL FRBRICR <br />Filed: 03/29/2017 02:12 Pr <br />Total $ <br />Unpaid Balance <br />of Assessment <br />(f) <br />10349.77 <br />10349.77 <br />, on this, <br />Signature i 44 -e-k - Titl <br />REVENUE OFFICER <br />for PAT'R KELLOGG (308) 663 -6003 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tex lien <br />24 -06 -3124 <br />