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Ma r. 28. 2018 3:54PM NE Secretary of State — UCC No. 3876 F. 2 <br />Form 668 (Y)(c) <br />(Rev. February 20041 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #6 <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 notke 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 Iien 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 TOMS DELIVERY SERVICE INC <br />a Corporation <br />Residence <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 8325(a). <br />Kind of Tax <br />(a) <br />941 <br />Place of Filing <br />Tax Period <br />EDding <br />(b) <br />Signature <br />for COLB SCHWAN <br />11874 <br />09/30/2017 <br />Identifying Number <br />(c) <br />the 22nd day of February 2018 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />XX- XXX6303 <br />Serial Number <br />2407 W 4TH ST <br />GRAND ISLAND, NE 68803 - 4507 <br />Date of . <br />Assessment <br />(d) <br />12/25/2017 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />Part 1 - Kept By Recording Office <br />297903418 <br />Last Day for <br />Refiling <br />(e) <br />01/24/2028 <br />Title <br />REVENUE OFFICER <br />(402) 473 -4671 <br />For Optional Use by Recording Office <br />NE 5.e of Moto John 5 0.I - UCC FTL <br />I , I <br />I I <br />li I <br />I I II 'I <br />I 1 I <br />9918808238 -3 Pee: 1 <br />TOMS DELIVERY SERVICE INC A Co <br />Filed 03/26/2018 11:24 AM <br />Total $ <br />201801940 <br />'I I <br />II i I <br />Unpaid Balance <br />of Assessment <br />10' <br />19200.11 <br />19200.11 <br />This notice was prepared and signed at CHICAGO IL , on this, <br />26 -15 -2722 <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 -4.86, 1971 - 2 C.B. 409) Form 668(Y)(c) !Rev. 2 -2004) K <br />CAT. NO 60025X <br />