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11/15/2001 16:59 FAX 14024714429 NEBRASKA UCC <br />109 Depar ' e ,;,gi • r r n a. ;n I Rig <br />Form 668 (Z) <br />(Rev. 10 -2000) Cert� �. e►f,a,rr <br />Area: =Seril umbe r <br />SMAIJ, BUSINESS /SELF EMPLOYED AREA Lien Unit Phone: (414) 297 -3211 479202680 <br />1 certify that the following -named taxpayer, under the requirements of section 6326 (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 e321 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 July 22 <br />1992 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />SHIRLEY & JIM INC , a Corporation <br />Residence BOX 576 <br />GRAND ISLAND, NE 68802 -0576 <br />COURT RECORDING INFOR T-IQ 'Tz:,- <br />Liber Page UCC No. Serial No. <br />n/a n/a n/a 92- 106351 �� albsi <br />Tax Period ate -ef'' <br />Kind of Tax I Ending identifying Numberl Assessment <br />940 <br />940 <br />941 <br />941 <br />941 <br />941 <br />941 <br />Place of Filing <br />12/31/1989 47- 0714397 10/07/1991 <br />12/31/1990 47- 0714397 10/07/1991 <br />09/30/1990 47- 0714397 10/14/1991 <br />12/31/1990 47- 0714397 10/14/1991 <br />03/31/1991 47- 0714397 04/13/1992 <br />06/30/1991 47- 0714397 04/06/1992 <br />09/30/1991 47- 0714397 04/06/1992 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE <br />This notice was prepared and signed at <br />the 11th day of __November <br />2001 <br />68802 -1692 <br />Omaha, NE <br />ap <br />Z 003/004 <br />Last Day for <br />Refiling <br />JIM rNC <br />!1512001 03:10 PM <br />200111752 <br />Unpaid Balance <br />of Assessment <br />11/06/2001 <br />661.63 <br />" --1/06/2001 <br />646.61 <br />11/13/2001 <br />3682.40 <br />11/13/2001 <br />8408.4-2 <br />05/13/2002 <br />5761.72 <br />05/06/2002 y <br />6537.96 <br />05/06/2002 I <br />6434.87 <br />Total 1$ <br />32133.61 <br />, on this, <br />Signature i Title Compliance Technical Support <br />� I 0" Manager <br />(NOTE: Certificate of officer authorized byWvv to take acknowledgments Is not essential to the validity of Lrertuncaie or neiodsn u, <br />Federal Tax lien Rev, Rul. 71 -466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10 -2000) <br />part 1 - RECORDING OFFICE CAT, NO 600261 <br />I <br />