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Mar. 28. 2019 3:47AM NE :-:n-tart' _f =tit — UCC <br />201Wii5294. <br />NE Sec of Slate - Robert B. Evnen <br />ng Document #: 1903001429-3 Pages: 1 <br />Debtor Name: n d a CARPET SBRVICPS INC A COIYPORAT <br />filing pr.rr .nal 'rime; 03/202019 01:3Z PM <br />Form 669 (Y)(r) <br />!Re, Caerua,y 20011 <br />3353, <br />Department of the Treasury - Internal Revenue service <br />Notice of Federal Tax Lien <br />Area <br />SMALL Bt1.9TD1613S/BELE EMPLOYER AREA #6 <br />Lien Unit Phone: (goo) 913-6050 <br />Serial Number <br />347324119 <br />For Optional Use by Recording Office <br />As provided by section 6321, 6322, and 63123 of the internal Revenue <br />Code, we are giving a nailce that taxes (including interest and penalties) <br />have been assessed against tate fallowing -named taxpayer. We have made <br />a demand for payment of this liability, but it remains unpaid. Therefore, <br />there is a Hen 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 B & B CARPET SERVICE INC <br />a Corporation <br />Residence PO SPX 6 <br />DONIPHAN, NE 60832-0006 <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 shell, <br />on the day followintd such date, operate as a certificate of release as defined <br />in IPC e325(al- <br />/ <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date or <br />Assessment <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- 2291 <br />01/07/2019 <br />02/06/2029 <br />26759.98 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NP 68802-1692 <br />$ 26759.98 <br />This notice was prepared and signed at <br />the <br />19thday of March <br />CHICAGO, IL <br />2019 <br />, on this, <br />Signature 3 Title <br />v REVENOE OFFICER 26-15-2722 <br />for CO1413SCHWAN (402) 473-4671 <br />_ I <br />(NOTE: Certificate of officer authorized by law to fake acknowledgment is not essentlal to the validity of Notice of Federal rax lien <br />Rev, Fttd. 71-406, 19?1 - 2 C-6, 4091 <br />Part I - Kept By Recording Office Form 669C0(c) (flee. 2-2004) <br />CAT. NO 60025X <br />