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Form 668 (Z) <br />,Rey, 10 -2000) <br />5216 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA # 4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />1760123 15 <br />For Use by Recording Office <br />Ns see <br />of si.i. <br />io„n fi <br />G.l - <br />Il[C LGFT <br />I certify that the following -named taxpayer, under the requirements of section 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 />_ <br />additions has been released. The proper officer in the office where the notice of <br />internal revenue tax lien was filed <br />on September 30 <br />991677519B-2 es: <br />1 A CORPORATION <br />the books. to show the release of this lien for <br />2015 <br />, is authorized to note <br />Filed: 061e9/2016 12!13 PM <br />these taxes and <br />additions. <br />Name of Taxpayer <br />GIGGLES INC, a Corporation <br />Residence 7.409 N WEBB RD <br />GRAND ISLAND, NE 68803 -2313 <br />COURT RECORDING INFORMATION: <br />Liber Page <br />BCC No. Serial <br />No. <br />n/a n/ a <br />9 201506707 <br />Tax Period <br />Date of <br />Last Day for <br />- Unpaid $alanc <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Reflling <br />of Assessment <br />(a) <br />( <br />(c) <br />(d) <br />(f) <br />941 <br />12/31/2014 <br />XX- XXX8886 <br />07/13/2015 <br />_fie) <br />08/12/2025 <br />21950.98 <br />******************************************* <br />* * <br />* * * * * * * * * * * *t <br />* * * * * * * ** * * * * * ** <br />Place of Filing - <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 21950.98 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the <br />Jun. 9. 2016 3:55PM NE Secretary of State - UCC <br />Signature <br />18th day of May <br />2016 <br />CHICAGO, IL <br />2 n 0 6 60 5 <br />, on this, <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 hen Rev. Rul. 71 -466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT NO 800261 <br />