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Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (Boo) 913 -6050 <br />Serial Number <br />798503911 <br />For Use by Recording Office <br />N E See of S Me John A 6•le - ICS CRFTL <br />I certify that the following -named taxpayer, under the requirements of section 6325 (a) <br />of the Internal Revenue Code has taxes <br />satisfied the 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 proper officer in the office where the notice of <br />11 <br />I' <br />1111111 <br />1 <br />internal revenue tax lien was filed <br />on Jelly 21 <br />9915757489 <br />- 9 P <br />1 <br />2011 <br />, is authorized to note <br />the books to show the release of this lien for <br />RPQ <br />0 9/ 2015P11:10 <br />these taxes and <br />additions. <br />Filed; R M <br />Name of Taxpayer <br />ISLAND SUPPLY COMPANY, a Corporation <br />1221 W OKLAHOMA AVE <br />Residence 1221 W OKLAHOMA AVE <br />GRAND ISLAND, NE 68801 -6652 <br />COURT RECORDING INFORMATION: <br />Liber Page CC No Serial No. <br />n/a n/a 9 '1667179 -2 201105346 <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Ref <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />941 <br />09/30/2010 <br />XX- XXX0945 <br />06/06/2011 <br />07/06/2021 <br />4632.06 <br />941 <br />03/31/2011 <br />XX- XXX0945 <br />06/20/2011 <br />07/20/2021 <br />4942.43 <br />******************************* <br />* *+X* <br />* **** * * * * * <br />* * *,k***** ***Nr <br />k * * * * ** * #**+Arakvl ** <br />I. <br />Place of Filing <br />Register of Deeds <br />Hall POSOX 1692 Total <br />$ 9574.49 <br />Grand Island,,NE 68802 -1692 <br />Jul. 9. 2015 2:52FM NE Secretary of State — UCC <br />Form 668 (Z) <br />(Rev. 10 -2000) <br />the <br />Signature <br />17th day of June <br />No. 1718 F'. 6.6 <br />11290 Department of the Treasury - Internal Revenue Service 2 01 5 `# <br />0 ;g G 3 7 <br />Certificate of Release of Federal Tax Lien 0 <br />This notice was prepared and signed at CHICAGO, IL on this, <br />2015 <br />Title Director, Specialty Collections <br />(NOTE: Certificate of officer authorized by law to take acknowledgments Is not essential to the validity of Certificate of Release of <br />Federal Tax lien Rev. Rul. 71 -466, 1971 - 2 C.8. 409) <br />Fnrm #4( r711 <br />