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<br />01/24/2008 THU 15:22 <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br />200800608 <br /> <br />~002/003 <br /> <br />~ <br />o Form 668 (l) <br /> <br />(Rev, 10-2000) <br /> <br />1924 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal T~ Lien <br /> <br />Area: . Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800)913-6050 388019307 <br /> <br />I certify that the following-named taxpayer, under the requirements of section 6-325 (a) <br />of the Internal Revenue Code has satisfied the taxes listed below and ail 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 September 12 <br />. 2 0 0 7 ,is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br /> <br />Name of Taxpayer <br />JOEL-B SHAFER <br /> <br />For Use b <br /> <br /> <br />Office <br /> <br />NE .see af $t.t. John .R Gala - UCC I=REL <br /> <br /> <br />9908844719-3 Pgs, 1 <br />SHAFER JOEL B <br />Flled, 01/24/2008 11:46 AM <br /> <br />" <br /> <br />Residence 66 PONDEROSA DR <br />GRAND ISLAND, NE 68803-9673 <br /> <br />Liber <br />ilia <br /> <br />COURT RECORDING INFORMATION: <br />UCC Serial No. <br />200707851 <br /> <br />Kind of Tax <br />a <br />1040 <br />******** <br /> <br /> <br />Identifying Number <br />f;} <br />XXX-XX-0675 <br />************* <br /> <br />Date of <br />Assessment <br />(d} <br />11/15/2004 <br />********** <br /> <br />Last Day for <br />, Refillng <br />(e} <br />12/15/2014 <br />************ <br /> <br />Unpaid Balance <br />of Assessment <br />f} <br />10043.03 <br />**************** <br /> <br />Place of Filing <br /> <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br /> <br />Total $ <br /> <br />10043.03 <br /> <br />This notice was prepared and signed at <br /> <br />ST PAUL, MN <br /> <br />, on this, <br /> <br />the <br /> <br />15th day of January <br /> <br />2008 <br /> <br />Sign~ture <br /> <br /> <br />Title Direct<;>r, Campus Compliance <br />Operat~ons <br /> <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 eZ) (Rev. 10-2000) 'L--"'_' <br />Pan I . RECORDING OFFICE CAT, NO 600261 V- <br />