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10/01/2012 MON 15:16 FAX 402 471 4429 UCC SECRETARY OF STATE ��� Hall <br />�ooa�oo5 <br />�0120�19� <br />Q� Form 668-�H <br />(Rev. Oetober 2004) <br />Area Oftic�e <br />SB/SE #9 <br />Department of the Treasury — Intemal Revenue 5ervice <br />Certificate of Release of <br />Federal Estate Tax Lien <br />Serial numbar <br />I certify that the requirements of section 6325(a) of the Intemal Revenue Code <br />have been satisfied for the tax liability (including ali statutory addiaons) shown <br />below on the followtng-named estate, and that the lien for the tax and statutory <br />additions has been released. The p �u� 23 & Jul� 2ge office�uF�e e notice of <br />internal revenue tax was filed on y y , , <br />is � <br />authorized to note in the books the �eleas as far as it relates to <br />the following. INST#a2004U7338 CCii9904343580-7 <br />Name of Estate Estate of John C. Davis <br />(For Optional Use by Recording Of�ice) <br />Name and address of agent designated by the qualified heirs for dealing wlth IRS <br />Daniel P. Davis <br />14960 W. Cedarview Road <br />Wood River, NE 68883 <br />Date of death <br />04 <br />Description of property to which lien attaches <br />Qualified Heirs: Francis T. pavis, John T. Davis, James D. Davis, Daniel P. Davis, Michael J. Davis, Kevin A. Davis and <br />Karen A. Rieke <br />SEE ATTACHED LEGAL DESCRIPTION <br />Placx� of Filing County ReCOrder <br />Hall County Grand Island. NE 68801 <br />This notice was prepared and signed at San Jose, Califomia � on <br />this <br />� 5th day of September � 2012 <br />5ignature � TiUe <br />� <br />Doug Hotfel #0682708 / �Advisor - Estate Tax Lien i <br />Part 3-- To be kept by Recording Offce Cataiog No 16744N www.irs.gov <br />0 <br />Pss: z <br />2 11:51 RM <br />Decedent's social security number (sSN) Amaunt of addidonal tax <br />XXX XX-9449 $ 295.063.00 <br />Form 668-H (Rev.10-2004) <br />i <br />_ <br />i � i w:, ��a� . . . . ..3 `�� i. <br />1 <br />