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NE Sec of State - Robert B. Evnen <br />Filing Document #: 2406000248-2 Pages: 1 <br />Debtor Name: TOMS DELIVERY SERVICE INC A CORPORA <br />Filing Date and Time: 06/11/2024 09:20 AM <br />04 <br />Form 668 (Z) <br />IRev. 10-2000) <br />5829 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: (800) 913-6050 <br />Serial Number <br />310105118 <br />For Use by Recording Office <br />I certify that the following -named taxpayer, under the requirements of section 6325 (al <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 June 15 <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 9918813818-0 201803829 <br />Tax Period <br />Date of <br />UutDayfor <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refilg <br />of Assessment <br />(a) <br />(b1 <br />(c0 <br />Id) <br />(a) <br />/f! <br />940 <br />12/31/2016 <br />XX-XXX6303 <br />05/07/2018 <br />06/06/2028 <br />758.63 <br />941 <br />12/31/2017 <br />XX-XXX6303 <br />04/02/2018 <br />05/02/2028 <br />22731.83 <br />*****************,r**,t,r,rr*********.*******+,r*********,t****. <br />***,re********,rw,r <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 23490.46 <br />Grand Island, NE 68802-1692 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />the <br />24th day of April , 2024. <br />Signature <br />ei..er <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. 4091 Form 668 (I) (Rev. 10-2000) <br />Parc I - RECORDING OFFICE CAT. NO 600261 <br />