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202101823 <br />NE See of State - Robert B. Evnen <br />Filing Document #: 2103000253-0 Pages: 1 <br />Debtor Name: CAREONE GROUP LLC <br />Filing Date and Time: 03/04/2021 09:25 AM <br />Form - * -8 (Z) <br />(Rev. 1020001 <br />17505 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS/SELF EMPLOYED AREA tt6 <br />Lien Unit Phone: (800) 913-6050 <br />Serial Number <br />395711419 <br />For Use by Recording Office <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 />additions has been released. The proper officer in the office where the notice of <br />internal revenue tax lien was tiled <br />on December 11 <br />2019 <br />, is authorized to note <br />the books to show the release of this lien for <br />these taxes and <br />additions. <br />Name of Taxpayer <br />CAREONE GROUP LLC <br />Residence2626 OLD FAIR RD <br />GRAND ISLAND, NE 68803-0000 <br />COURT RECORDING INFORMATION: <br />Liber Page <br />U C No._ <br />Serial No. <br />n/a n/a <br />191200048-4-3`- <br />21907795 <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 />Refilling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />941 <br />09/30/2018 <br />XX-XXX0924 <br />12/03/2018 <br />01/02/2029 <br />19572.19 <br />941 <br />06/30/2019 <br />XX-XXX0924 <br />09/02/2019 <br />10/02/2029 <br />2619.27 <br />+********************************************************,**•************* <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 22191.46 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />CHICAGO, IL <br />the 28th day of January , 2021, <br />Signature <br />Title <br />Operations Manager, <br />Centralized Lien Operation <br />on this, <br />(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of <br />Federal Tex lien Rev. Rul. 71-466, 1971 - 2 C.B. 4091 Form 668 (Z) IRev. 10-2000/ <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />