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05/10/2012 THU 14:30 FAX 402 471 4429 UCC SECRETARY OF STATE y�� Ball <br />�J002/002 <br />Form 668 (Z) 3592 Department of the Treasury - Internal Revenue Service <br />,Re�. ,a2000, Certificate of Release of Federal Tax Lien <br />Area: Serial Number <br />SMALL BUSINESS/SFI;F EMPLOYED AREA #4 <br />Lien Unit Phane: (soo) 913-6D50 410249536 <br />I certify that the tollowing-named.taxpayer, under the requirements of section 83251a) <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 Janua 23 <br />2 0 03 , is authorized to note the books to show the release of this lien for <br />these taxes and addltlons. <br />Name of Taxpayer <br />JOHN C& SIISAN M MEYERS <br />Residence11070 S BUFFALO RD <br />DONIPHAN, NE 68832-9721 <br />COIIRT RECORDING INFORMATION: <br />Liber Page IICC No. Serial No: <br />n/a n/a 9903254647-9 200300904 <br />Tax Period <br />Kind of Tax Endin� <br />Office . <br />991269 <br />MEYERS <br />Filed: <br />John A Gele - UCC QtFTL <br />� P9s: 1 <br />2012 12:47 PM <br />Date of I Last Day for I �Unpaid Balance <br />Assessment Refiling of Assessmeet <br />1040 12/31/1994 XXX-XX-3172 03/18/1996 04/17/2006 1476.96 <br />1040 12/31/200]. XXX-XX-3172 05/13/2002 06/12/2012 3741.35 <br />**��r**** �,�******** ,�***********� **t*�***�r* ***�***,�***�r ********,��*�**** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NFs 68802-1692 <br />Total � $ 5218 . 31 <br />This notice was prepared and signed at �aha, NE <br />the 25th day of April � 2012 <br />, on this, <br />Signature ^ — � <br />. �� ` <br />1 <br />Title <br />Operations Manager, <br />Centralized Case Processing-Lien Unit <br />(NOTE: Certificate of officer authorized by law to take acknowledgments is not essentlal to the velidity of Certificata of Release of <br />Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Form 668 (Z) (Rev. 10-2000) <br />Part f- RECORDING OFFICE CAT. NO 600261 <br />r` i <br />; : <br />� <br />i <br />I <br />� <br />. i <br />