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03/08/2010 t~SpN 14:54 FAX 402 471 4429 UCC SECRETARY pF STATS ~~w Hall <br /> <br />Form bb8 (Y)(c) <br />(Rev. Fehruary 2004) <br />201001521 <br />Department of the Treasury.,. In~arnal Revenue Service <br />Notice off' Federal ?ax Lien <br />Name of Taxpayer SCOTT A <br />GOLF USA <br />Area; Serial Number <br />9MAT,L BUSINESS/SELF SMPLOY1wA AREA, #4 <br />Lien Unit Phone: (800) 913-6050 629715810 <br />As provided by section b321, b3Z2, and b323 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 far the amount of these taxes, and <br />additional penalties, interest, and costs that may accrue. <br />HA <br />Residence 10Qg N DIERS AVE STE 230 <br />GRAND ISLAND, NE 68803-4962 <br />IMPQRTANT 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 a& a certificate of release as defined <br />in IRC 632li(a), <br />Kind of Tax <br />940 <br />941 <br />941 <br />941 <br />941 <br />941 <br />Place of Filing <br />syz <br />For Optional Use ey Recording Office <br />NE Seq Ef SkAke .lehn R Cale - UCC FTL <br />i <br />9910621820-7 Pys: 1 <br />GALUSHA SCOTT A <br />Filed: 03/08/2010 11:19 Af9 <br />Date of ~ ~. Last Day for <br />Assessment Refilling <br />(d (e <br />12/21/2009 01/2o/2ozo <br />12%28/2009 01/27/2020 <br />12/28/2009 01/27/2020 <br />i2/2s/2oo9 01/27/2020 <br />12/28/20Q9 '01/27/2020 <br />12/z$/2oo9 '~01/2~/2020 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Unpaid Iaalance <br />of Assessment <br />Bolo/oil <br />138.30 <br />1930.50 <br />942.50 <br />79.$7 <br />523.83 <br />417.64 <br />.. Total ~$ 4032.64 <br />This notice was prepared and signed at CHICAGO, IL <br />the <br />Signature <br />26th day of _February 2010 <br />on this, <br />for DANIELLE L MUELLER <br />Title <br />REVENUE OFFICER 24-10-1720 <br />(402) 473-4675 x2912 <br />Tax Period <br />Ending Identifying Number <br />b) (c <br />].2/31/2008 6$0540509 <br />06/30/2008 6$-0540509 <br />09/30/2008 68-0540509 <br />03/31/2009 68-0540509 <br />06/30/2009 68-0540509 <br />09/30/2009 68-0540509 <br />~n~r~c: c;ertiticate 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. 409) <br />Part 1 -Kent B1r Recording Pffice Form bde(Y)(t) lRev. 2-2004) <br />nn't •~n rnnor_v <br />