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09/22/2010 OrED 15:18 FAX 402 471 4429 UCC S1~CR8TA1tY OF STATE ~y~ Ha11 ~~ dorm 668 (Y)(c) IRev. February 2004) Department of the Treasury -Internal Revenue re ~•~ ~_ ~k.~. Jo1+n p ~+~. - VC[ pTL Notice of Fedeira[ Tax Lien 59 Area: Serial Numkaer F' SMALL BUSINi~58/S)tiLF EM]?LOYED AREA #4 lien Unit Phone: ($OO) 829-3903 699695514 9910638051-5 Past 1 As provided by section 8321, 6322, and 6323 of the Internal Revenue ~°i:d~a9G0xRi°201o 0s:2s ar+ Code, we are giving a notice that taxes (including interest and penalties) have been assessed against the following-named taxpayer. We have made a demand for payment of this liability, but it remains unpaid. Therefore, there is a lien in favor of the United States on ail property and rights to property belonging to this taxpayer for the amount of these taxes, and additional penalties, interest, and costs that may accrue. ame of Taxpayer Cx2 Residence 2124 LAWRENCE LN ].11 GRAND ISLAND, NE 68803-1757 IMPORTANT R@I,~ASE INFORMATION: Far each assessment listed below, unless notice of the lien is refiled by th® date given in column le), this notice shall, an the day following such date, operate as a certificate of release as defined in IRC fi3251a). Tax Period Date of Last Dayy for Kind of Tax Ending Identifying Number Assessment Reflling a fib) (c) (d) e 1044 12/31/2005 XXX-XX-0563 ].2/07/2009 01/05/2020 1040 12/31/2006 XXX-XX-0563 11/02/2009 12/02/2019 Place of Filing Register of Deeds Ha11 POBOX 1692 Grand Island, NE 68802-1,692 23915.10 21860.02 Total ~$ 45775.12 This notice was prepared and signed at CHTCAGD, IL the Signature 14th day of September 2010 ----. on this, for MICHAEL W. COX Title ACS (800) 829-3903 2414Q688E Unpaid Balance of Assessment 24-00-0008 (PIV[ E: Certificate of officer authorized by few tp take acknowledgment is not essential [a the validity ut Notice of Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Part t - Kept By Recording OEFfce Form 668(Y)(c) {Rev. 2-2004) \~• CAT. NO 60025X X002/002