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<br />01/05/2007 17:14 FAX 14024714429 <br /> <br />NEBRASKA Dee <br /> <br />~ 003/006 <br /> <br />S' <br /> <br />Fonn 668 (Y){c) <br />(Rev. February 2004) <br /> <br />200700158 <br /> <br />12479 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Notice of Federal Tax. Lien <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 331199506 <br /> <br />As provided by section 6321, 6322, and 632.3 of the Internal Revenue <br />Code, we are givin; 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. lberefore, <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 /> <br />Name of Taxpayer KIDZ CLUB INC , a Corporat~on <br /> <br />For Optional Use b <br /> <br /> <br /> <br />Residence <br /> <br />1721 S ARTHUR ST <br />GRAND ISLAND, NE 68803-6320 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice at the lien is ratHed by the date given in column (e), this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC 6325(a). <br /> <br /> Tax Period Date of ' Last D~ for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment left Ing of Assessment <br />a (b) c (d) (e (0 <br />940 12/3'1/2003 48-1293229 09/18/2006 10/18/2016 5165.84 <br />940 12/31/2004 48-1293229 09/18/2006 10/18/2016 323.26 <br />940 12/31/2005 48-1293229 09/18/2006 10/18/2016 308.04 <br /> <br />Place of Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />Total $ <br /> <br />5797.14 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />I on this, <br /> <br />29th day of November <br /> <br />2006 <br /> <br />the <br /> <br />Signature <br /> <br /> <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br /> <br />24-10-2339 <br /> <br />for KAY PONTE <br /> <br />(NOTE: Cartificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien yc <br />Rev. Ru!. 71-466, 1971 . 2 C.B. 4091 - Form 668(Y)(c) (Rev. 2-20041 ( . <br />, Part t . Kept By Recordinl Office CAT, NO 60Q25X '_~/ <br />