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08/04/2009 TUE 14:12 P'AX 402 471 4429 UCC 58CRETARY pF STATE ~yy Ra11 <br />dorm bb8 (1()(c) <br />IR®v..February 2004) <br />X003/003 <br />8U1 <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 />Department of the Treasury -Internal Revenue Service <br />Notice of ,.~.~dera~ Tax Lien........_ <br />Area: y, Serial Number For Optional Use by Recording Office <br />.S')1~~L BUb'~1~'rua~i/.~7~.,"'~1~' h'MPLQYLI3 AREA #4 NE Svc of Sia+v <br />Lien Unit Phone: (800) 913-6450 568059909 Ilrr~~ru~a..,....__.lw~~ o ~_. <br />Name of Taxpayer 4~TILLIS SHOE AND BOOT INC a Corporate <br />Residence 379 N WALNUT ST <br />GRAND ISLAND, NE 68801-4513 <br /> <br />Kind of Tax Tax Period <br />Ending <br />Identifying Number Date of <br />Assessment Last D for <br />Refi~ng <br />a (b) (c) (d) (e) <br />940 12/31/2008 47-0821358 05/11/2009 06/10/2019 <br />941 03/.31./2009 47--082135$ 07/06/2009 08/05/2019 <br />IMPORTANT RELEASE 1NFQRMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given in column (e1, this notice shall, <br />on the day following such date, operate as a certificate of release as defined <br />in IRC B325(a). <br />Place of filing <br />284.32 <br />3802.29 <br />Register of Deeds <br />Ha~.l POBOX 1692 <br />Grand Island, NE 68802-1692 <br />WllllS SHOD q6 -..•• nq,"/11UlIIi <br />Fllad: 0B/a4/~®g00T INCpgq C <br />10:47 AM <br />Total ~ $ 4086 , 61 <br />This notice was prepared and signed at <br />the 24th day of July <br />CHICAGO, IL <br />unpaid Balance <br />of Assessment <br />2009 <br />on this, <br />Signature ~ N <br />for PATRICK J KELLOGG <br />Title <br />REVENUE OFFICER <br />(308) 384-4850 <br />24--10-1744 <br />2oooos4sg <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. Hul. 79-466, 1971 - 2 C.B. 4091 <br />Part 1,.-.Kept By Recording Office Farm 668(Y)(c) (Rev. 2-20p4) <br />._ CAT. NO 6002aX <br />