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Oct, 26. 2013 2:41FM NE 'Seertary of state <br />201807103 <br />Nc, 1173 <br />44 <br />NE Sec of State - John A. Gilt <br />Filiwa; TAtwneat 0: 1610001722-t Pages: l <br />Debtor Nam: MCD.NEIBBA,SLA PT-OORRQG at DECIGN INC <br />Filing Date and Time 10f26120I B 10:49 AM <br />J <br />form 668. (Y)(c) <br />It4... February 29041 <br />11874 <br />Department of the Treasury - internal Revenue Service <br />Notice of Federal Tax. Lien <br />Area <br />S1yALL BUSINESS/SELF Ea'Loy£D ARRA #F <br />Lien Unit Phone; (000) 91 -6054 <br />Serial Number <br />32949911' <br />For Optional Use oy Recorolnp Office <br />As provided by section 6321, 6322, and 6323 of the Internal Roman. <br />Code, We are. giving a notice that takes (Including interest and .penalties) <br />have been aSSelised against the following -»mad taxpayer. We have made <br />a demand for payment of this liability, but k remaluf pnpaid. Therefore, <br />there Is a lien in favor of the United States MI all property and rights to <br />property belonging .to this taxpayer for die amount of these taxes, and <br />additional penalties, interest, and cents that 'my atsrtte, <br />Name of Taxpayer MID -NEBRASKA FLOORING & DESIGN INt. <br />ISLAND FLOORING <br />a Corporation <br />Residence 515 9 WEBB RD <br />GRAND ISLAND, NE 68803-514.2 <br />IMPORTANT RELEASE INFORMATION: For each assessmentlisted below, <br />unless notice of the lien to raffled by the date given in ooltamntel, this notice shall, <br />on the day following such date, operate es a certificate of release ea defined <br />In IRC 6326(0), <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />06/30/2016 <br />09/36/2016 <br />03/31/2017 <br />identifying Number <br />(c) <br />XX-XXX2617 <br />X2-)312617 <br />XX--X3CX2617 <br />Data of <br />Assessment <br />(d) <br />04/09/2018. <br />04/09/2918 <br />04/09/2018 <br />Lase Day for <br />Reftling <br />(e) <br />05/09/2028 <br />05/09./2028 <br />05/09/2028. <br />Unpaid Balance <br />of Assessment <br />(f) <br />7322.55 <br />5596.27 <br />1385.95 <br />941 <br />941 <br />941 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />0 14304.77 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the 16th day of October 2018 <br />Signature �� <br />�/ <br />for COLS CHWAN <br />Title <br />'REVENUE OFFICER 26-15-2722 <br />(402) 473-4671 <br />(NOTE: Certificate of officer nuthorited 6y law to take acknowledgment la not manual to the vaielty or Notice of Federal Tax flan <br />Rev. Rut. 71468. 1571 - 2 C.B. 409) <br />Part t - Kept By Yaeerdlnp Office Form 668(Y)(c) (Rev, 2.20041 <br />CAT. NO 60025X <br />