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Jun. 15. 2018 3:25PM NE Secretary of State — UCC <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (Boo) 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 beionging 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 6325(a). <br />Kind of Tax <br />(a) <br />940 <br />941 <br />Pace of Piling <br />This notice was prepared and signed at <br />the <br />30th day of May 2018 <br />Signature <br />for COLB <br />11874 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Serial Number <br />2407 W 4TH ST <br />GRAND ISLAND, NE 68803-4507 <br />Tax Period <br />Ending <br />(b) <br />12/31/2 016 <br />12/31/2017 <br />CHWAN <br />Identifying Number <br />(c) <br />XX- XXX6303 <br />XX- XXX6303 <br />Date of <br />Assessment <br />(d) <br />05/07/2018 <br />04/02/2018 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />CHICAGO, IL <br />310105118 <br />Last Day for <br />Refiling <br />(e) <br />06/06/2028 <br />05/02/2028 <br />Title <br />REVENUE OFFICER <br />(402) 473 -4671 <br />For Optional Use by Recording Office <br />Total $ <br />Nc. 4599 <br />201803829 <br />(0 <br />9918813818 -e Ps s; 1 <br />TOMS DELIVERY SERVICE INC A CO <br />Filed: 06/1512516 01.51 PM <br />Unpaid Balance <br />of Assessment <br />758.63 <br />22731.83 <br />23490.46 <br />, 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 - 46(3, 1971 • 2 C.B. 409) <br />Form 668(Y)(c) (Rev. 2 -2004) <br />