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07/11/2011 MON 14:57 FAS 402 471 4429 UCC SSCRETARY OF STATE �-�-� Hall <br />� 6 <br />Form 6 8 (1f)(c) <br />(Rev. February 2004) <br />Departrnent of the Treasury - Internal Revenue Service <br />Notice of Federal Tax Lien <br />A�ea: ' Seriai Number �. rwr o�t►onei use <br />sr�t, susr.r�ss/s� �r.o�n p,�, #4 <br />Lien Unit Phone: (800) 913-6050 797196311 <br />As provided 6y secdion 6321, 6322, and b323 of the lnternal Revenue <br />Code� we are giving a notice that taxes (includYng interest and penalties) <br />have been assessed aga�nst the foUowing-named taxpayer. We have made <br />a denwnd for payment of this Iiability, but it remains unpald. Therefore, <br />there is a tien in favor of the United States on ap property and rights to <br />property belonging to this taxpayer for the amount of these taxes, and <br />addit�onal penaities, interest, and costs that may accrue. <br />a Corporation <br />Residence 379 N WALNUT ST <br />GRAND ISLAND, NS 688U1-4513 <br />IMPORTANT LLEL�ASE INFORMATION For each assessment tisted below <br />unfess notice ot the lien is refiled by the date giveri in column (e), this notice shall, <br />on the day •following such date, operate as a certificate of release as defineai <br />Rn iRC 63251a). <br />Tax Period � Date of Laat D_ay for <br />Kind of Tax � Endieg tdentifyh�g Number Assessroent Ret�lieg <br />941 �03/31jZ011� 47-082].358 �06/13/2011� 07/13/2021 <br />Place af Filing <br />�jooz�oo5 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />�����'���.� <br />BOOT IPlG R (:OR <br />1 08:37 AM <br />tinpaid Balance <br />of Assessment <br />284.13 <br />Total �$ 284.13 <br />This notice was prepared and signed at � IL , on this, <br />the 29th day of J�e 2011 <br />Signature Titie <br />�� REVENL7E OFFICFsR 24-10-1744 <br />for PATRICK J KFLL (308) 384-4850 <br />(NOTE: Cerdficate of officer authorizad by law to teke ecknowledgment is not essertia! to the validity of No�ice of Federal Tax lien <br />Rev. Rul. 71-4¢6, 1971 - 2 C.B. 409) Form 668(ln(c) lRev. 2-2004) <br />• � Part f- K�t By Rewrding OHite reT �V1 QM�fGV <br />