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202305840 <br />NE Sec of State - Robert B. Evnen <br />Filing Document II: 2311000098-2 Pages: 1 <br />Debtor Name: TOMS DELIVERY SERVICE INC A CORPORA <br />Filing Date and Time: 11/06/2023 09:57 AM <br />Form 668 (Z) <br />{Rev. 10-20001 <br />3005 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: (B00) 913-6050 <br />Serial Number <br />290666917 <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 filed <br />on January 22 <br />2018 <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 />TOMS DELIVERY SERVICE INC, a Corporation <br />Residence2407 W 4TH ST <br />GRAND ISLAND, NE 68803-4507 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />n/a n/a 9918804801-4 201800433 <br />Tax Period <br />Mama <br />Last <br />Dpa�yy for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />lel <br />10 <br />941 <br />09/30/2016 <br />XX-XXX6303 <br />01/02/2017 <br />02/01/2027 <br />891.72 <br />941 <br />12/31/2016 <br />XX-XXX6303 <br />04/03/2017 <br />05/03/2027 <br />8776.85 <br />941 <br />03/31/2017 <br />XX-XXX6303 <br />07/03/2017 <br />08/02/2027 <br />15646.43 <br />941 <br />06/30/2017 <br />XX-XXX6303 <br />09/18/2017 <br />10/18/2027 <br />19442.42 <br />**,t***********************Pts*****v******x*** <br />****let******r*************,r** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 44757.42 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at <br />the <br />27th day of September, 2023, <br />CHICAGO, IL , on this, <br />Signature <br />Title <br />Operations Manager, <br />Centralized Lien Operation <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. 10-2000) <br />Part I - RECORDING OFFICE CAT. NO 600261 <br />