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Q4/23/2012 MON 15:48 FAX 402 471 4429 UCC SECRETARX OF STATE yy-� 8a11 <br />--�-- <br />Form 668 (Z) <br />�ReY. � asoao� <br />3 592 Department of the Treasury - Internai Revenue Service � Q� 2 0 3 2 2 8 <br />Certificate of Release of Federa[ Ta�c Lien <br />Area: Serial Number <br />SMALL BUSINE3S/SELF SMPLpYTD A1tEg #4 <br />Lien Unit Phone: (800) 913-6050 654293610 <br />I certify that the tollov✓ing-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 Cade 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 _ M3y 21 <br />2 O 10 , is authorized to note the booka to show the release of this iien for <br />these taxes and additions. <br />Name of Taxpayer <br />ROGELIO FUENTES <br />Residence1603 TflT JOHAT ST � <br />GR,AND ISLAND, NE 68801-6322 <br />COURT CORDTNG INFORMATION: <br />Liber Page II o. Serial No. <br />n/a n/ 9910627949-5 201003498 <br />Kind of Tax <br />�1005/005 <br />CpFTL <br />Date of I Last Day for I llnpaid Balance <br />Asseument Refiting of Assessment <br />1040 12/31/20�02 XXX-XX-66I6 02/27/2006 03/28/20Z6 43�17.63 <br />1040 12/31/2003 XXX-XX-6616 02/27/2006 03/28/2016 11016:69 <br />1040 12/31/2Q04 XXX-XX-6616 12/08/2U08 Ol/07/2019 16806.35 <br />1040 12/31/2006 XXX-XX-6616 11/16/2009 12/16/2019 11956.33 <br />**�t***** *�***�**�� *�****�r***,�** ****�r****�r ******�r*�**�t **�***�***�**�r** <br />Place uf Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, N 68802-1692 <br />Total I$ 44097.00 <br />This notice was prepared and signed at �ICAGO, IL <br />the llth day of April � 2012 <br />, on this, <br />Signature Title <br />���C�.� Operations Manager, <br />Centralized Case Processing-Lien Unit " <br />(NOTE: Certificate of of�cer authorized by law to take acknowledgments is not essentia! to the validity of Certificate of Release of <br />Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000) <br />Parc 1• RECORDING OPFICE CAT. NO 600261 <br />2 09:38 RPl <br />i <br />F <br />f <br />� <br />E <br />,l <br />� <br />