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07/20/2011 WRD 15:30 FAR 402 471 4429 UCC SECRETARY OF STATE ~~~ 8a11 <br />, � <br />Form 668 ('1f)(c) <br />IRev. February 2a04) <br />3 <br />Department of the T�easury - Internal Revenue Service <br />Notice of Federal Tax l.ien <br />Area: Serial Numbec <br />sruwz, �vs=r�:ss/s�� �rro�n Ax�. �� <br />Lien Unit Phone: (800) 913-6050 7985039],1 <br />As provYded by section 6321, 6322, and 6323 of the lnternal Revenue <br />Code, we are giving a notice that taxes (inctuding interest and pena[ties) <br />have been,assessed against the followiag-named taxpayer. We have made <br />a demand for payment of this liability, bnt it remains uepaid. Therefore, <br />there is a lien in favor of the tinited States on atl property and rights w <br />property be[onging to this taxpayer for the amount of th�sse tax�t, and <br />additional penatcies, interest, and costs �that may aurue. <br />Name of Taxpayer ISLAND SIIPPLY COMPANY, a Corporation <br />12 21 W OKLAFiOMA A' <br />Residence 1221 Ld ORLAHOMA AVS <br />GRAND TSLAND, NE 68801-6652 <br />tMPORTANT RELEASE iNFORMATION: For each assessment listed below, <br />unless notice of the lien is refiled by the date given Pn column {e), this n�tice shall. <br />on the day following such date, operate as a certificate of releese as defined <br />in IRC 6325(a). <br />Tax Period . � Date of Last D_ay for <br />Kimd of Tax Ending Ident�fj►ing Number Assessmeet Refiling <br />Use 6Y Recording Qfflce <br />Nfi See of 5lpke Jeim p 6s1e � YCC FTL <br />991l687379-2 Pss: 1 <br />ISLHND SUPPIY COI�ANY, R CORPO <br />Filed: 0�i20ia01� �m:za art <br />�0�.105�4� <br />llnpaid Balance <br />of Assessment <br />941 {09/30/2010I 47-0200945 �06/06/2011I 07/06/2021 <br />941 (03/31/2011 47-02009�45 06/20/2011 07/20C2021 <br />Place af Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 <br />�p02/005 <br />4632.06 <br />4942.43 <br />Total �$ 9574.49 <br />This notice was prepared and signed at � IL <br />the 06th day of July 2011 <br />, <br />, on this, <br />Signature � � Title <br />REVENUE OFFICER 24-10-1739 <br />for RAY PONTE (308) 384-4850� <br />(NOTE: Certificete of offtcer authorized by law to take acknowledgment is �ot essential to the validity of Notice of Fede�al Tax lien <br />Rev. Rul. 79-4�ifi, 7971 - 2 C.B. 409) Form 668(n(t) IRev. 2-24U41 <br />� Part t- Kept By Recording Off[ce . �•� •�� �����., <br />� <br />i <br />i <br />� <br />I <br />�1 . <br />