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Feb. 27. 2019 3:11FM NE Secretary cf State <br />NES.* of Sate - Rot a H. E+nen <br />Filing Document #:1902002072-7 Pages: 1 <br />Debar Name: CHOCOLATE BAR INC. A CORPORATION <br />Filing Date end Time: W27/201901:21 PM <br />J <br />Form 668 (Y)(c) <br />(Rev. "reerueiy20041 <br />17489 <br />Department of the Treasury - internal fievenue Service <br />Notice of Federal Tax lien <br />Area: <br />SMALL fUSINES9/8ELF 13MPL0YEn AREA #6 <br />Lien Unit Phone: (BOO) 913-6050 <br />Serial Number <br />343648519 <br />For Optional Use by Recording Office <br />_ <br />As provided by section 672. I, 6322, and 6323 of the interna! 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 or 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 CHOCOLATE BAR INC, a Corporation <br />Residence • PO 130X 1665 <br />GRAND ISLAND, NE 68802-1665 <br />IMPORTANT RELEASE INFORMATION: For each assessment luted below, <br />uAlese notice of the lien is refiled by the date given in column ie), this notice shall, <br />on the day following such date. operate as a cerdticete of release as defined <br />in (RC 63281a). <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />identifying Number <br />(c) <br />Date of <br />Assessments <br />(d) <br />Last Day for <br />Refiling <br />(e) <br />Unpaid Balance <br />of Assessment <br />(F) <br />941 <br />09/30/2018 <br />XX-1XX5435 <br />11/26/2018 <br />12/26/2028 <br />7707.09 <br />Place of Filing <br />Register of Deeds <br />Hail POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />8 7707.09' <br />This notice was prepared and signed at <br />the <br />CHICAGO, IL <br />15thdaY 4f Febrluary 2019 <br />Signature <br />for COLEIJsCHWAN <br />, on this, <br />Title <br />REVENUE OFFICER. <br />(402) 473-4671 <br />26-15-2722 <br />(NOTE; Certlf)cele of officer authorized by few to takes acknowledgment le not eseendai to the validity of Notice or Federel Tax lien <br />Rev. Rut. 71-468, 1971 - 2 C.D. 409) <br />Part t - Root Ry Recording Office Form bbB(tf)(e) (Rev. 2-2004) <br />CAT. NO e0025x <br />