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O1/19/2011 GtEA 15:10 FAX 4U2 �71 4429 UCC SECRETA1tX OF STATB ��y Hall <br />�� <br />Form 6be cY)(s) <br />(Rev. February 2004) <br />Department of the Treasury - Internal Revenus Service <br />l�latite o� Federat Tax Lien <br />Area: Serial Numlae� <br />sr+�,� svs�crr�ss/s�r�F �i,o�n �atr� #� � <br />Lien Unit Phone: (80U) 913-60�0 . 741735911 <br />As provided by section 632 t, 6322, and 6323 0� tlra Inten�al Raevenue <br />Code, we are gfving a notice that taxes (including intere�rt and penaltirs) <br />have been asseued against the foffowing-named taxpayer. We have made <br />a demand for payment vf this liability, but it remains unpaid. Therefore, <br />there is a lien in t'avor af the llnited States an alt property and rights to <br />property belonging ta this taxpayer for the amaunt oE these taxes, and <br />addi4ional penalties, interest, and coxts that may accrue. � <br />Name of Taxpayer GIGGLES �NC, a Carpora�ian <br />Residence 14 0 9 N WEBB RD <br />GRAND ISLAND, NE 6$$03=2313 <br />For <br />�DA3/005 <br />2o�foo��:� <br />Use bv Recnrdinq �ffice . <br />NE SaF Af fiel■ John q fial• �(1CC FTl <br />9911648729-6 Pss: i <br />GIGGI.ES ING R CORPORA7ION <br />Fllad: 0111�/2011 09:51 RM <br />IMPORTANT R�LEASE INF�RMATION For each assessment listad below, <br />untess 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 IRC 6325(a1. <br />Ta� Periad Date of Last �ay for <br />Kind of Tax Ending Identiiying Number Assessment Re�iting <br />9�� ��.z/3�./zoo�� zo-zoosaa� �oe/oz/aoio� 09/o�./zo�o <br />Place of Filing <br />llnpaid �lance <br />of Assessment <br />7284.23 <br />Register of D�eds <br />Hall POSOX 1692 <br />Grand 2sland, NE 6 880 �-1 692 <br />Total �$ 728� • 23 <br />This notice was prepared and signed at <br />the � day af January <br />CHICAGO, ZL <br />2011 <br />, on this, <br />Signature Title <br />�� REVENUE OFFTCER 24-10-172p <br />�or DANIELLE L M[7ELL (402) 473--4675 x2912 <br />(NOTE: Certificate of officer authorized by law to take acknowledgment is not essential to the val+dity of Notice of Federal Tax lien <br />Rev. Rul. 71-468, 1977 - 2 C.B. 409) Form 6b$(1f)(C) (Rev. Z-20041 <br />part 1- Kept By Recording Oftite CAT. Np 60025X <br />