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06/29/2004 15:46 FAX 14024714429 NEBRASKA UCC 11t003 /003 NE S.e e! Si., CC FM 9804340388_4 ESTATE OF JOHN C. DAVIS Pa.: 1 Fl led: 06/29/2004 ii!SB RM 200406'741 Form 668 -H Department of the Treasury — Internal Revenue Service (Rev. Nov. 1999) Notice of Federal Estate Tax Lien Under the Internal Revenue Laws District: Small Business /Self Serial Number: For optional Use by Recording Employed #9 Office Notice is given under the provisions of section 6324B of the hiternal Revenue Code that alien exists in favor of the United States against the specific property described below for additional Federal estate tax imposed by section 2032A (c) due to the special valuation elected under section 2032A, and / or section 2057 (i). Section 2032A (c) X Section 2057 (f) Name of Estate: Estate of John C. Davis Name and Address of agent designated by the qualified heirs for dealing with the IRS. Daniel P. Davis 14960 W. Cedarview Road Wood River, NE 68883 Date of Death: Decedent's Social Security Number: Amount of Additional Tax: 04 -01 -2002 508 -18 -9449 $ 295,063.00 Description of Property to Which Lien Attaches: Qualified Heirs: Frances T. Davis, John T. Davis, James D. Davis, Daniel P. Davis, Michael J. Davis, Kevin A. Davis and Karen A. Rieke The East Half of the Southeast Quarter (E112 SE1 /4) of Section Fourteen (14), Township Ten (10) North, Range Twelve (12) West of the 6th P.M., Hall County, Nebraska Part of the Northeast Quarter (NE1 /4) and part of the East Half of the Northwest Quarter (E112 NW1 /4) of Section Twenty -nine (29), Township Ten (10) North, Range Twelve (12) West of the 6th P.M., Hall County, Nebraska Place of Filing: County Recorder Hall County Grand Island, NE 68801 This notice was prepared and signed at Saint Paul, Minnesota, on this, 23ls day of June '2004. Signature: Title: Technical Services Group Manager y� TO BE KEPT BY THE RECORDING OFFICE Form 668 -H (Rev 11 -99) t Ale"