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<br />03/18/2009 WED 14:30 FAX 402 471 4429 UCC SECRETARY OF STATE ~~~ Hall <br /> <br />idJ002/010 <br /> <br />,.9(1 <br />lJVI"orm 668 (Z) <br /> <br />(Rav. 10-2000) <br /> <br />8801 <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 159552204 <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 March 05 <br />2004 , 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 U!'lF! hv Rl'>....nr~in,., ,,-F-F;...... <br /> <br /> <br /> <br />~ ~~l1Ir1Ir1111\1' r <br /> <br /> <br />9909590390-3 pgs: 1 <br />WAGONER THOMAS A <br />Filed: 03/18/2009 11 :19 AM <br /> <br />200901964 <br /> <br />Residence 1819 W NORTH FRONT ST <br /> GRAND ISLAND, NE68803-4706 <br /> COURT RECORDING INFORMATION: <br />Liber Page ~o.-~ Serial No. <br />n/a n/a 904321284 200402078 <br /> , -- Unpaid Balance <br /> Tax PeiiOCf Date of Last Da.r. for <br />Kind of Tax Ending Identifying Number Assessment Refi 109 of Assessment <br />(al (Ill (eJ (d) te) (fl <br />941 12/31/2001 47-0550792 11/18/2002 12/18/2012 <br />941 12/31/2001 47-0550792 01/27/2003 02/26/2013 902.46 <br />941 03/31/2002 47-0550792 10/28/2002 11/27/2012 <br />941 03/31/2002 47-0550792 01/27/2003 02/26/2013 705.43 <br />941 03/31/2003 47-0550792 02/09/2004 03/11/2014 1876.62 <br />941 06/30/2003 47-0550792 02/02/2004 03/04/2014 1831. 30 <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 />5315.81 <br /> <br />This notice was prepared and signed at <br /> <br />CHICAGO, IL <br /> <br />, on this, <br /> <br />the <br /> <br />04th day of March <br /> <br />2009 <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 V <br />Federal Tax lien Rev. Ru!. 71-466. 1 971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000) <br />Pan: 1 - RECORDING OFFICE CAT. NO 600261 <br />