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05/17/2011 TUE 15:04 FAx 402 471 2530 LICEN5ING S$C OF STATS ��� �all <br />�l <br />D� Form b68 (Y)(c) <br />{Rev. February 20041 <br />K3 <br />Area: Seria{ f�umber ' <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (S00) 913-6050 784532611 <br />As provided by section 6321, 6322, and 6323 of the Interna[ Revenue <br />Code, we are giving a notice that taxes (inciuding interest and penalties) <br />have been assessed against the foUowin$-named taxpayer. We have made <br />a demand for payment of this liabitity, but it remains unpaid. Therefore, <br />there is a lien in favor of the llnited States on all property and rights to <br />properiy belonging to this taxpa�rer for the arnount of these taxes, and <br />additional penalties, interest, and casts that may accrue. <br />Name of Taxpayer J G AND J INC, a Corporat <br />BULLWINKLES <br />Residence <br />2118 N WEBB RD <br />GR.AND ISLAND, NE 68803-1737 <br />�� NE Soc�o! 5tate Jahn R 6ata - UCC FTL <br />9911661759-6 P � <br />FiGed•. <br />�ooa/ooz <br />IMPORTANT RELEASE 111FORMATION For each assessment listed below, <br />unless notice of the lien is refiled by the date given in oolumn (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 />Tax Period Date of Last Da�y for <br />Kind of Tax Ending identifijrieg Number Assessment Refiling <br />a (b (�) (d) (e) <br />941 03i31/2010 47-0756101 04/25/2011 05/25/2Q21 <br />941 06/30/2010 47-0756101 04f25/2017. 05/25f2021 <br />941. 09/30/2010 47-0756101 04/25/2011 05/25/2021 <br />94Z 12/31/2010 �,7-075610I 04/25/2011 05/25/2021 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />llnpa�d Batance <br />of Assessment <br />3105.19 <br />4674.�1 <br />8548.26 <br />6148.68 <br />Totat �$ 22476.54 <br />This notice was prepared and signed at <br />the lOth day of May <br />CHICAGO, IL <br />�oll <br />, . <br />, on this, <br />Signature �� ' Titie <br />REVENUE OFFICER 24-10-1739 <br />for KAY PONTE (308) 384-4850 <br />(NOTE: Certificate of ofticer autho�ized by law to take acknowledgmont is not easontial to the validity ot Notice of Federal Tax lian <br />Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form b68(X)(c) (Rev. 2-2004) ., t. <br />Part 1- Kept By Recording Office • CAT. NO 600Z5X �/� <br />Department of the Treasury. - Internal Revenue Service <br />Notice of Federai Tax Lien 2 0110 3'715 <br />