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<br />07/28/2008 <br /> <br />rP <br /> <br />MON 15:30 <br /> <br />FAX 402 471 4429 UCC SECRETARY OF STATE <br /> <br />......... <br /> <br />Hall <br />200806458 <br /> <br />1dJ0 0 71 0 0 7 <br /> <br />Form 668 (Z) <br />(Rev. 1 Q..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 />lien Unit Phone: (800) 913-6050 127989203 <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 August 15 <br />20 03 ,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 />THOMAS A WAGONER <br /> <br />For Use by Recording Office <br /> <br />ImrllIn'ln~rr <br /> <br />9908566974-9 pgs: 1 <br />WAGONER THOMAS A <br />Filed: 07/28/2008 02,46 PM <br /> <br />Residence1819 W NORTH FRONT ST <br />GRAND ISLAND, NE 68803-4706 <br /> <br />COURT RECORDING INFORMATION: <br />Liber Page UCC Nn Serial No. <br />n/a n/a (9903290321-3) 200310716 <br /> <br />Tax Period Date of Last Day for <br />Kind of Tax Ending Identifying Number Assessment Refiling <br />fal (bl leI (d} fe} <br />941 12/31/2002 47-0550792 06/09/2003 07/09/2013 <br />********~**********~************* **********~************ <br /> <br />Unpaid Balance <br />of Assessment <br />{fJ <br />141.19 <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 />141.19 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />17th day of July <br /> <br />2008 <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. Ru!. 71-466, 1971 - 2 C.B. 409) <br />Part . - RECORDING OFFICE <br /> <br />Form 668 (Z) (Rev. 10-2000) <br />CAT. NO 600261 <br /> <br />~ <br />