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1h1 <br />Vj <br />12/28/2004 09:31 FAX 14024714429 NEBRASKA UCC <br />U002/003 <br />1872 <br />Department of the Treasury - Internal Revenue Service 200412414 <br />Form 668 (Y)(c) Notice of Federal Tax Lien <br />IAwv February 2004) <br />Area: Serial Number For Optional Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA 49 <br />Lien Unit Phone: (651) 312 -8080 205995004 <br />Iri Lie sI 64aN UCC FTL <br />As provided by section - 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that ta ces (including interest and penalties) <br />have been assessed against the follo in -named taxpayer. We have made <br />a demand for payment of this ll�bil' , but it remains unpaid. Therefore, <br />there is a lien in favor of the u States on all property and rights to <br />Pps: 1 <br />9904388376 -3 <br />property belonging to this taxp for the amount of these taxes, and BERM ENTERPRISES INC. R COMR <br />additional penalties, interest, ancc�sts that may accrue. Filed:. 12J27l2004 03:69 PM <br />Name of T ;c ayer BEAM ENTERPRISES INC a Corpora -Lion <br />i <br />Residence ip0 nOX 910 <br />GRAND ISLAidD, 68802- (910 <br />i <br />IMPORT T RELEASE INFO ATI(m For each aEsessment listed below, <br />id <br />unless n i e f the lien is refiled by the date given colu n je), this notice shall, <br />on the d y f (lowing such date, o ;era }}etas a certificate of release as defined <br />in IRC 6 5(6). I i <br />T4x Period <br />pRp <br />I <br />Date of <br />Last ��rr for <br />R <br />Unpaid Balance <br />Assessment <br />Kind of Tax <br />nding <br />Ide. t <br />g Num <br />r <br />Assessment <br />i'mg <br />of <br />(a) <br />(b) <br />t I <br />( ) <br />1 <br />(d) <br />�) <br />(f) <br />941 <br />06/30/2004 <br />' <br />I <br />47-011813659 <br />i <br />i <br />10/11/2004 <br />1 <br />I <br />i <br />I <br />i <br />i <br />11 / <br />I <br />)/201;4 <br />23325.85 <br />PIE <br />ce of Fii <br />in <br />Register of <br />ends <br />Hall POBOx <br />1692 <br />Total <br />$ 23325.13-5 <br />Grand iIsland, <br />NE 6 <br />802ti1,692 <br />This <br />notice <br />as <br />pr <br />pared and signed at <br />ST PkUL <br />, MN <br />, on this, <br />th <br />Ot <br />d <br />y of Dedember) <br />2004 <br />I <br />Si nature <br />I REVENUE OFF I li <br />ER <br />29-10-2341 <br />Or PAT <br />�i <br />I�IL,GG <br />I (308) 384 -6612 <br />�(NOTE <br />ertafica <br />a of officer authorized b <br />Ia <br />to take acknowledgment <br />is not essential to <br />he validity of <br />otice of Federal Tax lien <br />Rev. Rt <br />I: <br />j11 -466 <br />1971 - C.Bi 409) <br />( <br />Part 1 . K <br />m � 13V Lecordbw Office <br />F <br />668(Y)(c) (Rev. 2 -2004) <br />r A r n+n cnn ')c v <br />7 <br />v <br />