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04/07/2004 09:00 FAX 14024714429 NEBRASKA UCC <br />� i� <br />(! k <br />141003/004 <br />This notice was prepared and signed at <br />the 31st day of March <br />2004, <br />Omaha, NE <br />on this, <br />Signature Title Compliance Technical Support <br />Manager <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 666 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />I <br />L L - <br />1008 Department of the Treasury - Internal Revenue Service ,`1 <br />Form 668 (Z) <br />2"'04M <br />Certificate of Release of Federal Tax Lien <br />(Rev. 10 -2000) <br />Area: <br />Serial Number <br />For Use by Recording Office <br />SMALL BUSINESS /SELF EMPLOYED AREA #9 <br />NE Us or s4.4.. ucc TEE <br />Lien Unit Phone: (651) 312 -8080 <br />390260719 <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 />9904327060 -4 Pas: 1 <br />internal revenue tax lien was filed on September 17 <br />WAGONER THOMAS A <br />2002 , is authorized to note the books to show the release of this lien for <br />Filed! 04/06/2004 04:00 PM <br />these taxes and additions. <br />Name of Taxpayer <br />THOMAS A WAGONER <br />Residence 1819 W NORTH FRONT ST <br />GRAND ISLAND, NE 68803 -4706 <br />COURT RECORDING INFORMATION: <br />Liber Page UC-G—Ia�°'—" Serial. No . <br />n/a n/< 9902235262 -8 200209853 <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 />Re Mg <br />of Assessment <br />la) <br />(b) <br />(Cl <br />(d) <br />(e) <br />(f) <br />941 <br />09/30/1998 <br />47- 0550792 <br />07/12/1999 <br />08/11/2009 <br />272.32 <br />941 <br />06/30/2000 <br />47- 0550792 <br />03/19/2001 <br />04/18/2011 <br />272.09 <br />941 <br />06/30/2001 <br />47- 0550792 <br />01/07/2002 <br />02/06/2012 <br />198.33 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 742.74 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 31st day of March <br />2004, <br />Omaha, NE <br />on this, <br />Signature Title Compliance Technical Support <br />Manager <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 666 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />I <br />