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A02000317 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2001000880-1 Pages: 1 <br />Debtor Name: PROMPTCARE LLC <br />Filing Date and Time: 01/15/2020 12:26 PM <br />03 <br />Form 668 (Y)(c) <br />iBev. Febr a,y 20041 <br />17505 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA #6 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />400504120 <br />For Optional Use by Recording Office <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 belonging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />Name of Taxpayer PROMPTCARE LLC <br />Residence 1300 S LOCUST ST <br />GRAND ISLAND, NE 68801-0000 <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 ollowing such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refillng <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />941 <br />941 <br />06/30/2019 <br />09/30/2019 <br />XX-XXX0372 <br />XX-XXX0372 <br />09/02/2019 <br />12/02/2019 <br />10/02/2029 <br />01/01/2030 <br />16041.97 <br />16457.03 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 32499.00 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />03rd day of January 2020 <br />Signature <br />is - a-_ e <br />for COLBY SCHWAN <br />Title <br />REVENUE OFFICER <br />(402) 473-4671 <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. Rut. 71466, 1971 - 2 C.B. 4091 Form 668(Y)(c) (Rev. 2-2004) <br />Part I - Kept By Recording Office <br />CAT. NO 60025X <br />