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oa/21/2p10 wEa 14:42 <br />Form 6b8 (Y)(t) <br />iRev. February 20Q4) <br />FAK 402 471 4429 ^CC SECRETARY OF SxAT13 ~y~ Hall <br />~oozloos <br />Department of the Treasury -Internal Revenue Service <br />Notice of Federal Tax Lien <br />Area: Serial Number ~ For. Optional Use by Recardin pfFice <br />SMALL BUSYNESS/SELF EMPLQYED AREA #4 <br />Lien Unit Phone: (800) 829-3903 642059210 <br />NE Sec of qb/Y Jahn R Oslc - l1CC FTL <br />As provided by section 6321, 63'22, 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 an all property and rights to <br /> <br />property belonging to this taxpayer for the amount of these taxes, and gg~0625080-1 Pss: , <br />MIDWEST MUFFLER & EXHRU5T IHC <br /> <br />additional penalties, interest, and casts that may accrue. Filed: 04/21/2010 09:27 qM <br />Name of Taxpayer MIDWEST MUFFLER & EXHAUST xNC <br /> <br />~ JOEL B SHAPER C nn <br />2 ~ 1 ~~ 2 D~ .J <br />Residence 113 5 S LOCUST ST <br />GRAND ISLAND, NE 68801-6771 <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 fvllawing such date, operate as a certificate of release as defined <br />in IRC f3325(al. <br /> Tax Period Date of Last Dayy for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Refiling of Assessment <br />a ~ b c (d) (e) f) <br />941 03/31/2009 75-2973107 Ofi/15/2009 07/15/2019 30].9.60 <br />941 06/30/2009 75-2973107 08/24/2009 09/23/2019 7753.76 <br />941 Q9/3D/2009 75-2973107 11/2.3/2009 12/23/2019 9526.53 <br />Place of Filing <br />Register of Deeds <br />Ha7.l POBOX 1692 <br />Grand Island, NE 68802-7.692 <br />Total ~$ 20299.89 <br />This notice was prepared and signed at <br />the 07th day of April <br />Signature <br />for MICHAEL W_ cnx <br />an this, <br />Title <br />ACS <br />(l~nn~ >a~~1_~an~ <br />24-00--0008 <br />CxxCACO, IL <br />201D <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the validity of Notice of Federal lax lien <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 666(lf7(c) iRev. 2-200 <br />Part 1 - LCept 13y Recording Office re-r Nn ann~tiY <br />