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NE Sec of State - RobertB. Emen <br />Filing Document #: 2301000838-5 Pages: 1 <br />Debtor Name: TOMS DELIVERY SERVICE INC A CORPORA <br />Filing Date and Time: 01/18/2023 09:17 AM <br />202300274 <br />Form 668 (Y)(c) <br />(9ev. Fnb,,ary 70041 <br />17628 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA 46 <br />Lien Unit Phone: (800) 9].3-6050 <br />Serial Number <br />464528922 <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 TOMS DELIVERY SERVICE INC <br />a Corporation <br />Residence 2407 W 4TH ST <br />GRAND ISLAND, NE 68803-4507 <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 8325(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 />Refiling <br />(e) <br />Unpaid Balance <br />of Assessment <br />(f) <br />941 <br />941 <br />941 <br />09/30/2019 <br />12/31/2019 <br />03/31/2022 <br />XX-XXX6303 <br />XX-XXX6303 <br />XX-XXX6303 <br />04/06/2020 <br />04/06/2020 <br />07/25/2022 <br />05/06/2030 <br />05/06/2030 <br />08/24/2032 <br />26035.77 <br />20015.53 <br />1866.30 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802-1692 <br />$ 47917.60 <br />This notice was prepared and signed at ... <br />the ........ <br />19th December 2022 <br />day of <br />CHICAGO, IL <br />, on this, <br />Signature <br />for COLBY SCHWAN <br />Title <br />REVENUE OFFICER <br />(402) 473-4671 <br />26-14-4822 <br />1NOTE: certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal TAX lien <br />Rev. Rut. 71-466. 1971 - 2 C.B. 409) Form 66t3(Y)(c) (Rev. 2-2.004) <br />Part i - Kept By Recording Office CAT. NO 60025X <br />