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10/23/2012 TUE 14:24 FAX 402 471 4429 UCC SECRETARY OF STATE ��� Hall <br />Form 668 (Z) <br />(Rev. i Q-2000) <br />3592 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federat Tax Lien <br />Area: <br />3MALL BUSINESS/SELF £NIPLOYED AREA #4 <br />Lien Unit Ph ( 913-6050 <br />Serial Numher <br />874650912 <br />i certify that the following-named taxpayer, under the requiremetrts of secdon 6325 (a) <br />of the Internal Revenue Code has satisfied the taxes listed below and all statutory <br />additions. Therefore, the lien provided by Code section 6321 for these taxes and <br />additions has been released. The prope� officer in. the office where the notice of <br />internal revenue tax lien was.filed on June 25 <br />2 012 , is authori2ed to note the books to show the release of this lien for <br />these taxes and additions. <br />WILLIS SHOP AND BOOT INC, a Corporation <br />�004/004 <br />Residence 3 79 N WA.LNUT ST <br />GRAND TSLAND, NE 68801-4513 <br />COURT RECORDING INFORMATION: <br />Liber Page U . Serial No. <br />n/a 9912694502-4 201205145 <br />Kind of Tax <br />Date of Last Da�yfor tlnpa�d Balance <br />Assessment Refil'mg of Auessment <br />941 06/30/2011 47-0821358 02/13/2012 03/15/2022 2316.14 <br />941 09/30/2011 47-0821358 02/13/2012 03/15/2022 5208.39 <br />941 12/31/2011 47-0821358 02/27/2012 03/29/2022 5850.86 <br />******** *�,���***** *****�*,�***�* **�*****�* *��***�*�*�* *�**�**,�,r**,�*�** <br />t <br />� <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />I <br />Total $ 13375.39 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the lOth day of �Ctober � 2012 <br />Signature ��{ <br />Title <br />Operations Manager, <br />Centralized Case Processing-Lien Unit�� <br />(NOTE: Certificate of officer authorized by lew to take acknowledgments is n�t essentiel to the validity of Certificate of Release of � <br />Federal Tax lien Rev. Rul. 71-486, 1979 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000} <br />Part f- RECORDING OFFICE CAT. NO 600261 <br />For Use by Recording Office <br />��012U�8��➢ <br />