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03/30/2010 TUE 15:24 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br />3592 <br />Department of the Treasury -Internal Revenue <br />Form 668 (Y)(c) <br />X002/003 <br />Service <br />IRev. February 20pai Notice o~ Federal Tax Llen <br />Area: Serial Number For Optional Use 6y Recording Office <br />SMALL BUSINESS/SEZF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 635713410 <br />AS provided by section 6321, 6322, and b323 of the Internal Revenue NF Soe of SlNe John A G~)e -UGC FT4 <br />Code, we are gluing a notice that taxes (including interest and penalties) <br />have been assessed against the fallowing-named taxpayer. We have made <br />a demand far payment of this liability, but it remains unpaid. Therefore, <br />there Is a lien in favor of the united States an all property and rights to <br />property belonging to this taxpayer For the amount of these taxes, and a4aeszaas7-7 Pas: 1 <br />additional penalties, interest, and casts that may accrue. FpBed~OS 30/g20~0 12:31 Ph <br />Name of Taxpayer EDWARD D SABATKA - <br /> ` <br />' <br /> ~ U ~ <br />2 010 0 <br />~ <br />Residence <br />2624 S LOCUST ST , <br />GRAND ISLAND, NE 68801-8228 <br />IMPORTANT RgLEASE 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 tRC 6325(a). <br /> Tax Period Date of Last Dayy for Llnpald Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />(a (b) c (d) a (f) <br />941 09/30/2005 48-0844616 0]./02/2006 02/01/2016 <br />941 06/30/2009 48-0$44616 09/21/2009 10/21/201.9 782.03 <br />941 09/30/2009 48-0844616 01/04/2010 02/03/2020 4866.44 <br />Place of Filing <br />Register of Deeds <br />Hall POSOX 1692 <br />Grand Island, NE 58802-1692 <br />Total ~$ 5648.47 <br />This notice was prepared and signed at <br />the <br />18th day of March <br />CHICAGO, IL <br />2010 <br />on this, <br />Signature ~ y I y~cl~ ACS 24-00-0008 <br />for MICHAEL W. COX (800) 829-3903 <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. 409) Form 668(Y)(c) IRev. 2-2004) <br />Part 1 -Kept By Retarding Office CAT. Nb fi0025X <br />