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202402415 <br />NE See of State - Robert B. Evnen <br />Filing Document #: 2405000785-9 Pages: 1 <br />Debtor Name: B & B CARPET SERVICE INC A CORPORAT <br />Filing Date and Time: 05/31/2024 09:04 AM <br />Form 668 (Z) <br />1Ree. 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 #6 <br />Lien Unit Phone: (B00) 913-6050 <br />Serial Number <br />352915119 <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 8321 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 May 07 <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 />B & B CARPET SERVICE INC, a Corporation <br />Residence PO BOX 6 <br />DONIPHAN, NE 68832-0006 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />n/a n/a 1905000394-9 201902608 <br />Tax Period <br />Date of <br />Last <br />Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(aJ <br />(b) <br />(c) <br />(d) <br />(e1 <br />M <br />941 <br />12/31/2018 <br />XX-XXX2291 <br />04/01/2019 <br />05/01/2029 <br />25210.02 <br />************************•*******..,r*****,r****************.*******ser****** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 25210.02 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />01st day of May 2024 <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 Tex lien Rev. Rut. 71-466, 1971 - 2 C.B, 4091 <br />Part I • RECORDING OFFICE Form 668 (2) (Rev. 142000) <br />CAT. NO 600261 <br />