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05/06/2009 )8 WED 15: 11 PAX 402 471 4429 UCC SBCRBTARY OP STATE ~~~ Hall 1ilI002/009 --*-- 8801 Department of the Treasury. Internal Revenue Service Certificate of Release of Federal, Tax Lien .;~~....', Form 668 (Z) IRe-I(. 1.0<2000) ;' I ~ '.':: ~ Area: Serial Number SMALL BUSINESS/SELF EMPLOYED AREA #4 Lien Unit Phone: (800) 913 -6050 206389904 I certify that the following-named taxpayer, under the requirements of section 6325 (a) of the Internal Revenue Code has satisfied the taxes listed below and all statutory additions. Therefore, the lien provided by Code section 6321 for thesa taxes and additions has been released. The proper officer in the office where the notice of internal revenue tax lien was filed on December 29 2 004 ,is authorized to note the books to show the release of this lien for these taxes and additions. For Use by Recording Office 9909595698-0 Pgs: 1 ALLEN CHARLES I'l Filed: 05/06/2009 09:38 AM Name of Taxpayer CHARLES MALLEN 200903498 Residence3424 PRIMROSE DR GRAND ISLAND, NE 68801-8765 Liber 2004 Page 12413 COURT RECORDING INFORMATION: Serial No. 12413 Kind of Tax a 1040 ******** Tax Period Ending bJ 12/31/2001 ********** Identifying Number Ie} XXX-XX-4666 ************* Date of Assessment IdJ 12/15/2003 ********** Last Day for Refiling e 01/14/2014 ************ Unpaid Balance of Assessment If} 10566.56 **************** Place of Filing Register of Deeds Hall POBOX 1692 Grand Island, NE 68802-1692 Total $ 10566.56 This notice was prepared and signed at CHICAGO, IL , on this, the 22nd day of Apri~_, 2009. Signature Title Director, Campus Compliance Operations (NOTE: Certificate of ollieer authorized by law 10 lake acknowledgments is not essential to the validity of Certificate of Release of Federal Tax lien Rev. Rut. 71-466.1971 - 2 ca, 4091 P.m I . RECORDING OFFICE Form 668 (Z) (Rev. 10-2000) CAT. NO 600261 y)