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Nov. 7. 2517 3:42PM NE Secretary of State — UCC No. 2545 P. 2/3 <br />form 666 (Y)(c) <br />(Rev. February 2004) <br />Residence <br />Kind of Tax <br />(a) <br />941 <br />941 <br />Place of Filing <br />Signature <br />for PATR <br />Tax Period <br />Ending <br />(b) <br />11874 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (800) 913 -6050 <br />Name of Taxpayer B & B CARPET SERVICE INC <br />a Corporation <br />03/31/2017 <br />06/30/2017 <br />This notice was prepared and signed at <br />the 26th day of October 2017 <br />,3tarJl- <br />3 I(ELLOGG <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />PO BOX 6 <br />DONIPHAN, NE 68832 -0006 <br />Identifying Number <br />(c) <br />XX- XXX2291 <br />XX- XXX2291 <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 />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 />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Date of <br />Assessment <br />(d) <br />07/10/2017 <br />09/11/2017 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 - 1692 <br />CHICAGO, IL <br />Part I • Kept By Recording Office <br />284114017 <br />Last Day for <br />Refiling <br />(e) <br />08/09/2027 <br />10/11/2027 <br />Title <br />REVENUE OFFICER <br />(308) 663 -6003 <br />20 <br />For Optional Use by Recording Office <br />I Sec .t S!.u. John N GPIs - NCC FTL <br />9917801314 -13 Pea: <br />B b B CARPET SERV CE INC A COR <br />Filed: 11/07/2017 01;10 PM <br />Total $ <br />Unpaid Balance <br />of Assessment <br />(C) <br />21817.83 <br />26520.41 <br />48338.24 <br />, on this, <br />26 -15 -2724 <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) Form 669(1()(1) (Rev. 2 -2004) <br />CAT. NO 60025X <br />