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12/14/2004 17:53 FAX 14024714429 <br />Fr� <br />NEBRASKA UCC <br />10006/008 <br />- - *-- <br />1872 Depa 4A lf�tmeirA t re s 11�teY Re' nue Service <br />Form 668 (z) <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 />Lien Unit Phone: (651) 312 -8080 <br />390263159 <br />Ni See o1 Siet. - UCG Te9 <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 on November 18 <br />8904365818 -8 P95: 1 <br />2002 , is authorized to note the books to show the release of this lien for <br />DREISBRCHS STEAKHOUSE INC, A C <br />these taxes and additions. <br />Filed: 121/4/2004 03:00 PM <br />Name of Taxpayer <br />DREISBACHS STEAKHOUSE INC , a Corporation. <br />200 41 ✓v 0 t <br />Residence 113 7 S LOCUST ST <br />GRAND ISLAND, NE 68801 -6771 <br />COURT RECORDING INFORMATION: <br />Liber Page iTCC °No .� "' °.Serial No . <br />n/a n/a C_q,02244694 -4 0212815 <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 />Refiiing <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(fl <br />941 <br />12/31/2001 <br />47- 0530472 <br />04/22/2002 <br />05/22/2012 <br />459.80 <br />941 <br />03/31/2002 <br />47- 0530472 <br />08/12/2002 <br />09/11/2012 <br />810.45 <br />941 <br />06/30/2002 <br />47- 0530472 <br />09/30/2002 <br />10/30/2012 <br />7369.59 <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 8639.84 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at <br />the 08th day of December <br />2004 <br />Omaha, NE <br />, on this, <br />Signature Title Director, Payment Compliance <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 />P..* i . RFrnRDINC. OFFICE rAT kin anr»al <br />