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J 26. 21117 3:43FM <br />Form 666 (Y)(c) <br />(Rev. February 2004) <br />11874 <br />A Serial Number <br />SMALL Bu7SINBSS /SELF EMPLOYED AREA 44 <br />Lien Unit Phone: (800) 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 TOURNEY BROTHERS METAL FABRICATION <br />, AN LLC <br />Residence <br />PO BOX 39 <br />WOOD RIVER, N2 68883 <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 IAC 6325(a). <br />Kind of Tax <br />(a) <br />941 <br />9 <br />941 <br />941 <br />Piece of Filing . <br />Tax Period <br />Ending <br />(b) <br />12/31/2015 <br />06/30/2016 <br />12/31/2016 <br />03/31/2017 <br />This notice was prepared and signed at <br />Identifying Number <br />(c) <br />XX- XXX8025 <br />XX- XXX8025 <br />XX- XXX8025 <br />XX- XXX8025 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />the 14th day of July 2017 <br />Signature <br />for PATR <br />KELLOGG <br />Jlebeic— <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Date of <br />Assessment <br />(d) <br />05/01/2017 <br />05/01/2017 <br />05/01/2017 <br />06/19/2017 <br />270351017 <br />Last Day for <br />Refiliing <br />(e) <br />05/31/2027 <br />05/31/2027 <br />05/31/2027 <br />07/19/2027 <br />Title <br />REVENUE OFFICER <br />(308) 663 -6003 <br />N 4152 F 2 /2 <br />201704971 <br />For Optional Use by Recording Office <br />E 5ec eF Slate JGi a Gale - IICC FT <br />I 1 I Ii <br />9917795527 -0 pas: 1 <br />F0i1sd; METAL AMRICA <br />Total $ <br />Unpaid Balance <br />of Assessment <br />() <br />5649.23 <br />11934.45 <br />7227.29 <br />303.09 <br />25114.06 <br />CHICAGO, IL , on this, <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 Tax lien <br />