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08/24/2010 TUE 10:40 FAX 402 471 4429 UCC SHCRETARY OF STATE a~~ Hall <br />3592 <br />Department of the Treasury -Internal Revenue Service <br />Form 6158 (Y)(c) <br />(Rev. February 2ooa1 Notice of Federal Tax Lien <br />Area: Serial Number For Op7iona <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913-6050 688349610 <br />As provided by section 6321, b322, 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 ail properly 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 />Name of Taxpayer FLS ANC <br />Residence 4014 BUCKINGHAM DR <br />GRAND ISLAND, NE 68803-6401 <br />IMPORTANT RELEASE INFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled py the date given in column (x), this notice shall, <br />an the day following such date, operate as a certificate of release as defined <br />in IRC 8325(x). <br />Tax Period Date of Last Dayy for <br />Kind of Tax Ending Identifying Number Assessment RefiLing <br />(a) b) (c) d (e) <br />940 ~2/3x/2oo9 za-5783258 05/03/2010 o6/.oz/2o2o <br />~. <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802--1692 <br />i~006/D09 <br />Use by Recording Office <br />NE Sae of S!r!q John A Crle -UCC F <br />9910635489-9 Pos: 1 <br />FL5 INC <br />Filed: 08!2412010 08:00 AM <br />Total ~$ 230.75 <br />This notice was prepared and signed at <br />the 12th' day of August <br />2010 <br />CHICAGO, IL <br />~oioo5ssi <br />unpaid Balance <br />of Assessment <br />230.75 <br />on this, <br />~, <br />Signature ~ y ~~ Title <br />REVENUE OFFICER 24-x0-1720 <br />for DANIELLE L MUELLER (402) 473-4675 x2912 <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. Ftul. 71-466, 7971 - 2 C.B. 409) Form bb8(Y)(c) (Rev. 2-20p4) <br />Part 1 -Kept BY Recordin8 Ofifice CAT. Np 60025X <br />