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01/20/2010 WED 15:39 FAX 402 471 4429 UCC SECRETARY OF STATE ~y~ Hall <br />`l <br />CHICAGO, IL <br />- - ~ 3 592 Department of the Treasury -Internal Revenue Service <br />Form bblB (Z) <br />,Rem. 10-2p~0) Certificate of Release of Federal Tax Lien <br />Area: Serial Number For Use b Recordin Office <br />WAGE & INVESTMENT AR>~P, #2 <br />L.len Unit Phone: (800) 913-6050 373098307 <br />I certify that the following-named taxpayer, under the requirements of section 6325 (a1 "~ ~•~ •f :+•+• ~•~+~+ a e•:• - ucc ceF <br />of the Internal Revenue Cada has satisfied the taxes listed below and all statutory <br />additions. Therefore, the lien provided by Cnde section 6321 for these taxes and <br />additions has been released. The proper officer in the office where the notice pf <br />internal revenue tax lien was filed an _ July 03 <br />2007 is authorized to note the books to show the release of this lien for 9930617238-6 pas: 1 <br />these taxes and addltlOnS. GOOSIC STEVEN E <br />Filed: 01/20!2010 01:12 PM <br />Name ofi Taxpayer <br />STEVEN E GOOSIC <br />Residence218 LAKESIDE DR <br />GRANn I <br />2 o i o 0 0 4~ o <br />SLAND, NE 68801-8536 <br />COURT RECORDING INFORMATION: <br />Liber Page o. Serial No. <br />n/a n/a. 9907516069-8 200705649 <br /> Tax Pe Date of Last Dayy for unpaid Balance <br />Kind of Tax Ending Identifying Number Assessment R~efiling of Assessment <br />a (b) c d e f <br />1040 12/31/2003 XXX-XX-9$74 12/18/2005 07./17/201.7 2860.01 <br />1040 12/31/2005 XXX-XX-9874 05/29/2006 06/28/207.6 3293.74 <br /> <br />Place of Filing <br />Register of Deeds <br />Ha11 POBOX 1692 Total $ 6].53.75 <br />Grand Island, NE 58802-1692 <br />This notice was prepared and signed at <br />the 11th day of January <br />Signature Q •, y;,l~ p® <br />Title Director, Campus Compliance <br />Operations <br />2010. <br />Ia1002/007 <br />on this, <br /> <br />s: <br />,. <br />i. <br />I. <br />i <br />Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C_B. 409) Form 6G$ (~) !Rev. 10-2000} ~ / <br />Part t -RECORDING OFFICE CAT, NO 600261 lJ <br />