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05/05/2005 09:08 FAX 14024714429 NEBRASKA UCC <br />1872 <br />Form 668 MW <br />(Rev. February 2004) <br />2005.04125 <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number I For Optione <br />SMALL BUSYNESS /SELF EMPLOYED AREA #9 <br />Lien Unit Phone: (800) .829 -3903 224393805 <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 J G AND J INC <br />JIM KERSHAN <br />I Use by <br />Q003/003 <br />Office <br />N9 Soc of 64&46 - VC[ FTL <br />i <br />i <br />i <br />9905393261-7 <br />Ftied 0 05/10�4C12005 03.53 an <br />Residence 3235 S LOCUST ST <br />GRAND ISLAND, NE 68801 -8816 <br />E:IRC 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 Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />(a) (b) (c) (d) (e) (f) <br />CIVP 12/31/2001 47- 0756101 09/27/2004 10/27/2014 5935.01 <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 ST PAUL, MN <br />the 21St day of APril 2005 <br />Total 1$ 5935.01 <br />, on; this, <br />Sig'rTatUre ACS 29-00-0008 <br />o,:S.;.K1L:ATRIGK (800) 829 -3903 <br />(hf i__0_- :erfific6te of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien <br />Rev: Ruti 71166, 1971 -`2 C.B. 409) Form 668(Y)(c) (Rev. 2 2004) (a <br />Dart 1 - Kmt By Recording Office CAT, NO 60025X j 1 <br />