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05/18 %2001 15:58 FAX 14024714429 NEBRASKA.UCC <br />1a002/002 <br />59599 p WX e $ur Ih rnal Re4lue Service <br />668 <br />Form (Z): <br />Ce i se of Federal Tax Lien <br />(Rev. 10-20001 ,o _ . _- . . <br />hiff of sta.. - o« <br />Area: Serial Number F <br />11141111111 1 {I <br />AREA <br />SMALL BUSINESS /SELF EMPLOYED ARA #9 <br />111111111 {11111 {'11111 <br />Lien Unit Phone: (414) 297 -3211 399931678 01142875 ` <br />COSGRIFF KMOL0 E <br />I certify that the following -named taxpayer, under the requirements of section 6325 (a) FNed: 0511er2o01 03.34 PM <br />of the Internal Revenue Code has satisfied the taxes listed below and all statutory <br />additions. Therefore, the lien provided by Code section 6321 for these taxes and <br />additions has been released. The proper officer in the office where the notice of <br />internal revenue tax lien was filed on May 11 <br />1999 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer HAROLD E COSGRIFF 200104689 <br />Residence RT 2 <br />DONIPHAN, NE 68832 -9802 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No.1-- �> <br />n/a n a n a 99- 104856 <br />Tax Period <br />Date of _ <br />r Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Re8ling <br />of Assessment <br />(a) <br />(b) <br />W <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/1993 <br />505 -48 -5731 <br />03/30/1998 <br />04/29/2008 <br />4872.68 <br />1040 <br />12/31/1994 <br />505 -48 -5731 <br />04/27/1998 <br />05/27/2008 <br />29222.30 <br />Place of Filing <br />Register of Deeds Total <br />$ <br />Hal POBOX 1692 <br />34094.98 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at MILWAUKEE, WI <br />the 14th day of May 2001 <br />, on this, <br />Signature Title Compliance Technical Support y, <br />Manager it <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.B. 409) Form 668 (Z) (Rev. 10 -20001, <br />Part 1 - RECORDING OFFICE CAT. NO 000261 <br />