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<br />07/28/2008 MON 15:29 <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />200806456 <br /> <br />1dI005/007 <br /> <br />OB <br /> <br />Form 668 (Z) <br />(Rev. 10-2000) <br /> <br />4653 <br /> <br />Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br /> <br />Area: Serial Number <br />SMALL BUSINESS/SELF EMPLOYED AREA #4 <br />Li~n Unit Phone: (800) 913-6050 222518305 <br /> <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 April 15 <br />2 005 , is .authorized to note the books to show the release of this lien for <br />these taxes and additions. <br /> <br />For Use b <br /> <br /> <br />liE s.. a# st.t. J...... A G.I. - UCC CRFTL <br /> <br /> <br />9908566972-5 P9S : 1 <br />WRGONER THOMAS R <br />Filed: 07/28/2008 02,46 PM <br /> <br />Name of Taxpayer <br />THOMAS A WAGONER <br /> <br />Residence 1819 W NORTH FRONT ST <br />GRAND ISLAND, NE 68803-4706 <br /> <br />Liber <br />2005 <br /> <br />Page <br />03327 <br /> <br />COURT RECORDING INFORMATION: <br />UCC No. Serial No. <br />9905389712~4 03327 <br /> <br />Kind of Tax <br />a <br />941 <br />******** <br /> <br />Tax Period <br />Ending <br />(b) <br />09/30/1999 <br />********** <br /> <br />Identifying Number <br />(e <br />47-0550792 <br />************* <br /> <br />Date of <br />Assessment <br />(d) <br />10/11/2004 <br />********** <br /> <br />Last D~ for <br />Refillng <br />(eJ <br />11/10/2014 <br />************ <br /> <br />Unpaid Balance <br />of Assessment <br />II <br />704.29 <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 />704.29 <br /> <br />This -notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />17th day of July <br /> <br />2008 <br /> <br />the <br /> <br />Signature <br /> <br /> <br />Title Director, Campus Compliance <br />Operations <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. 409) <br />Pan 1 . RECORDING OFfiCE <br /> <br />Form 668 (Z) IRev. 10-2000) <br />CAT. NO 600261 <br /> <br />0? <br />