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<br />12/23/2008 TUE 14:25 <br />U. <br />Q <br />Form 668 (Y)(c) <br />(Rev. February 2004) <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~4 Hall <br /> <br />121004/007 <br /> <br />8801 <br /> <br />Department of the Treasury - Internal Revenue Service <br /> <br />Notice of Federal Tax Lien <br /> <br />200810358 <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 500251508 <br /> <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 /> <br />Name of Taxpayer TRI-CITY AGENCIES INC , a Corporatlon <br /> <br />For Optional Use by Recording Office <br /> <br /> <br />9908580272-9 P9S: 1 <br />TRI-CITV AGENCIES INC . A CORP <br />Filed, 12/23/2008 12,59 PM <br /> <br />Residence <br /> <br />PO BOX 2600 <br />GRAND ISLANb, NE 68802-2600 <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 IRe 6325(a). <br /> <br />Kind of Tax <br />(a) <br />940 <br />940 <br /> <br />Tax Period <br />Ending <br />(b) <br />12/31/2004 <br />12/31/2005 <br /> <br />Identifying Number <br />(c <br />72-1542257 <br />72-1542257 <br /> <br />Date of <br />Assessment <br />(d) <br />10/29/2007 <br />03/24/2008 <br /> <br />Last Day for <br />Refiling <br />(e) <br />11/28/2017 <br />04/23/2018 <br /> <br />Unpaid Balance <br />of Assessment <br />(f) <br />6125.26 <br />3511. 62 <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 />9636.88 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />09th day of December <br /> <br />2008 <br /> <br />for MICHAEL W. COX <br /> <br /> <br />Title <br />ACS <br />(800) 829-3903 <br /> <br />24-00-0008 <br /> <br />Signature <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. Ru!' 71-466, 1971 ~ 2 C.B. 4091 Form 668(Y)(c) (Rev. 2.2004) <br />Part t - Kept By Recording Office CAT. NO 60025X <br /> <br />'V <br />