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10/19/2011 WED 14:47 FAX 402 471 4429 UCC SECRETARY OF STATE -�y-+ Hall <br />�' _. <br />Fo� b6a tY)c�� <br />iRev. February 2004) <br />03/31/2004 <br />06/30f2004 <br />09/30/2004 <br />12/31/2004 <br />03/31/2006 <br />09/30/2Q06 <br />03f31/2007 <br />06j30j2007 <br />09/30/2007 <br />12/31/20Q7 <br />Area: Serial Number <br />SMALL BUSINESS/SFs'LF EMPLOYED AREA #4 <br />Lien Unit Phone (800) 913-6050 819942211 <br />As provided by section 632t, 6322, and 6323 of the Internal Revenae <br />Code, we are giving a notice that taxes (inctuding lnterest and penalties) <br />have been assessed against the followiag-named taxpayer. We �ave made <br />a demand for payment of this ita6ility, 6ut it remains unpaid. Therefore, <br />there is a lien in favor of the Llnited States on all property and righu to <br />property 6eloeging to this taxpayer for the amount of these taxes, and <br />additional penalties, interest, and wsts that may accrue. <br />ame <br />�'�%� <br />0 <br />Residence 22Q OXNARD AV� <br />GRAND ISLAND NE 68801-6782 <br />For Oational Use <br />�Iooa�oos <br />lMPORTANT RELEASE INFORMATION For each assessment listed below, <br />unless notice of the lien is re�led by the data 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(a). <br />Tax Perlad • Date of Last Da�r for <br />Kind of Tax Ending idenf Number Assessment Refil�ag <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />9�1 <br />Place of Filing <br />09/05f2011 <br />a9/05/2011 <br />09/05/2011 <br />09/OS/2011 <br />09/05/2011 <br />09/05/2011 <br />08/29/2011 <br />os/29/2011 <br />08/29/2011 <br />os/29/2oa.i <br />Department ot the Treasury - Interna) Revenue Service <br />Notice of Federa� Tax I.ien 2 0110 7 8 41 <br />& MASER, a <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />27-5405920 <br />Register of Deeds <br />.. Hall POBOX 169.2 � <br />G I NE 68802-1692 <br />This notice was prepared and signed at .CHICAGO, IL� <br />the ��� day of October 20].l <br />. � <br />Signature <br />for��D�il�1TELLF� L <br />10597.53 <br />10701,72 <br />11010.1.� <br />11651.35 <br />8306.62 <br />11755.84 <br />8420.87 <br />7603.49 <br />9576.53 <br />9002.74 <br />� <br />Total I$• � 98626.79 � � <br />. -i <br />.; <br />, on this, <br />Title <br />REVENUE OFFICER 24-].0-1720 <br />(402) 473-4675 x29'12 � � � ' <br />lo/os/.2o21 <br />10f05/2021 <br />10/OS/2021 <br />1Q/05/2021 <br />10/05/2021 <br />10/�5/2021 <br />09/28/2021 <br />09/28/2021 <br />09/28/2021 <br />o9/Zalao2i <br />Unpafd Balance <br />of Assessment <br />(NOTE: Certificate of offtcer authorized by law to take acknowledgment•is not essential to the validity of NoUce of Federal Tax Ilen <br />Rev. Rv�• 71-466,•1979 - 2 C.B. 409) . ' ' Form 668(n(c) (Rev. 2 ZQ04) <br />� !art 1- Kept By Recording �Office' � CAT. NU 60025X <br />