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<br />10/31/2008 FRI 15:24 FAX 402 4714429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />121003/003 <br /> <br />rP <br /> <br />8801 <br /> <br />Form '68 (Y)(c) <br />(Rev. February 2004) <br /> <br />Department of the Treasury ~ Internal Revenue Service <br />Notice of Federal Tax Lien <br /> <br />200809162 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 484550408 <br /> <br />As provided by section 6321, 6322, and 6323 of the Internal Revenue <br />Code, we are giving a notice that taxes (induding 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 /> <br />Name of Taxpayer COFFEE N" CREAM INC , a Corporation <br /> <br />For Optional Use by Recording Office <br /> <br />Tlllnrrl\i'irl on <br /> <br /> <br /> <br />9908574847-0 Pss: 1 <br />COFFEE N CREAM INC , A CORPORA <br />Filed: 10/31/2008 03:00 PM <br /> <br />Residence <br /> <br />1247 N BURLINGTON AVE <br />HASTINGS, NE 68901-3011 <br /> <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled 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 />Kind of Tax <br />(a) <br />941 <br />941 <br /> <br />Tax Period <br />Endins <br />(b) <br />12/31/2007 <br />03/31/2008 <br /> <br />Identifyin, Number <br />(e) <br />71-0937456 <br />71-0937456 <br /> <br />Date of <br />Assessment <br />(d) <br />03/10/2008 <br />06/09/2008 <br /> <br />Last Day for <br />Refilln, <br />(e) <br />04/09/2018 <br />07/09/2018 <br /> <br />Unpaid Balance <br />of Assessment <br />(0 <br /> <br />73.29 <br />5899.30 <br /> <br />;- <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 />5972.59 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />21st day of October <br /> <br />2008 <br /> <br />the <br /> <br />Signature <br /> <br />Title <br />REVENUE OFFICER <br />for ERIC MARTIN (402) 437-5462 <br /> <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal Tax lien ~ <br />Rev. Rul. 71-466,1971 - 2 C.B. 4091, Form 668(Y)(c) (Rev. 2-200 <br />Part . ~ Kept By Recording Office CAT. NO 60025X \ <br /> <br /> <br />24-10-1721 <br />