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09/al/2009 TUE 14:34 FAX 402 471 4429 UCC $ECRBTARY OF STATE ~~y Hdll <br />_I <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />--*-- <br />fi orm bb8 (Z) S 191 Department Qf the Treasury -Internal Revenue Service <br />laev. 1o-aooo- Certiffcate of Release of Federal -Tax Lien <br />Area: Serial Number For Use~by Recordin Office <br />SMALL BUSINESS/SELF BMFLOYED AR~SA, #4 pE s.~ of Stata John R 6.Is -UCC tRFT4 <br />Lien Unlt Phone: (800) 913-6050 214z14105 <br />I certify that the fallowing-named taxpayer, under the requirements of section B325 (a) <br />of the Internal Revenue Code has satisfied the taxes listed below and alt statutory <br />additions. Therefore, the lien provided by Code section 8321 far these taxes and <br />additions has bean released. The proper officer in the office where the notice of 9909606000-7 P9g ~ 1 <br />internal revenue tax lien was filed on Februa„rY .,28 SALRZAR MARCELO <br />Filsd: 09/01!2009 09:23 AM <br />2 Q 0 5 <br />is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer ' <br />MARCELO SALA%AR <br /> <br />Residence 210 N PIPER APT 2 ~ ~ ~ ~ ~ +~ <br />GRAND ISLAND, NE 68803 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />2005 01629 9905381175-6 01629 <br /> Tax Period Date of L,a:t Day for Unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment Filing of Aueument <br />a (b c d e >r <br />1040 12/31/2002 XXX-XX-8555 04/15/2003 05/15/2013 <br />].040_ 12/31/2Q02 XXX-XX-8555 _10/25/2004 11/24/2014 $799.1.7 <br />******** **~***,r*** ************* ****~~r*~** ************ ****rr*********** <br />Place of Filing <br />Total I$ 8799.17 <br />This notice was prepared and signed at <br />the 19th day of August <br />Signature Q ~.t;.-liAi <br />Title Director, Campus Compliance <br />Operations <br />(NOTE: Certificate of officer authorized by law to take acknowledgments is nat essential to the validity of Certificate of Release of <br />• Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) 4Rev. 10-20001 <br />Part 1 - RECOQDING OFFICE CA7. NO 600281 <br />- i <br />2009 <br />CHICAGO, IL <br />~1oaz/aas <br />an this, <br />