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09/12/2012 6�tED 15:49 FAX 402 471 4429 UCC SECRETARY OF STATE ��y 8a11 <br />p� --*-- <br />Form 668 (Z) <br />�Re�. � o-2000� <br />�003/003 <br />3592 Department of the Treasury - Internal Revenue Service � o���� 6 2 9 + <br />Ce�tificate of Release of Federal Tax Lien <br />Area: Serial Number <br />SMALL BUSINESS/SSLF EsNiPLOYED AR�A #4 <br />Lien Unit Phone: (800) 913-6050 959716008 <br />1. certify that the following-named taxpayer, under the requirements of section 6325 (a) <br />of the Intemal 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 releas�. The proper officer in the office where the notice of ' <br />internal revenue tax lien was filed on _ AugLtst 07 I <br />2008 , is authorized to note the books to show the release of this lien for � <br />these taxas and additions. <br />i�ame or � axpayer <br />DENNIS M COLLINS <br />Residence1900 W PEACH CIR <br />LINCOLN, NE 68522-8719 <br />Liber page <br />n/a n/ <br />Kind of Tax <br />COIIRT RECORDING INFORMATION: <br />��� Serial No . <br />a 908567874-8 200806818 <br />Tax Per�od <br />Ending Idee <br />Date of I I.ast Day for I llnpaid Balance <br />Assessment RefllQng of Auetsment <br />1040 12/31/2002 XXX-XX-4730 10/23/2006 11/22/201G 10099.19 <br />1040 12/31/2003 XXX-XX-4730 11/13/2006 12/13/2016 1715.13 <br />1040 12/31/2004 XXX-XX-4730 09/18/2006 10/18/2016 1808.32 <br />*�r***�** �r��t**��t�** *****,�*,�*�*** *�r**�r***** �,�,�,�*�r*�t*,�** *�r�r*�e�e*�r****,��** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />For Use <br />Total �$ 13622.64 <br />This. notice was. prepared. and signed at �I�� � IL <br />the 29th day of August � 2012 <br />, on this, <br />Signature ^ — �� <br />� v� <br />Title <br />Op erations Manager, <br />�entralized Case Processing-Lien <br />(NOTE: Certificate of officer authorized by law to take acknowledgments is not essential to the validity of Certificate of Release of <br />Federal Tax lien Rev. Rul. 71-466, 1971 - 2 C.B. 409) Ferm 668 (Z) (Rev. 10-2000) <br />Part 1• RECORDING OFFlCE CAT. NO 600261 <br />