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w <br />08/03/2004 16:44 FAX 14024714429 NEBRASKA UCC 1�J003 /003 <br />200407712 <br />:% <br />J .� 1872 <br />Department of the Treasury - Internal Revenue Service <br />Form 668 MW Notice of Federal Tax Lien <br />(Rev. February 2004) <br />Serial Number For Optional Use by Recording Office <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 163859904 <br />Lien Unit Phone: (651) 312 -8080 <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 DREISBACHS STEAKHOUSE INC , a Corporat t on <br />Residence 1137 S LOCUST ST <br />GRAND ISLAND, NE 68801 <br />EIRC NT RELEASE INFORMATION: For each assessment listed below, <br />of the lien is refiled by the date given in column (e), this notice shall, <br />following such date, operate as a certificate of release as defined <br />(a). <br />Tax Period Date of Last Day for <br />Kind of Tax Ending Identifying Number Assessment Refilling <br />(a) (b) (c) (d) (e) <br />940 12/31/2002 47- 0530472 05/24/2004 06/23/2014 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 28th day of July <br />Signature T)a' rZ <br />wRrr.uAvT. G7 vnNTTF. <br />2004 <br />ST PAUL, MN <br />Total I$ <br />Fri <br />ac <br />Unpaid Balance <br />of Assessment <br />(f) <br />712.41 <br />712.41 <br />on this, <br />r <br />Title 2g -10 -2337 <br />REVENUE OFFICER <br />(308) 384 -6668 <br />(NO'M: Certificate of officer authorized by jaw to take acknowledgment is not essential tote va y r_..I cXaivvel (awv. 2 -2004) <br />