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10/OL/2012 MON 15:17 FAX 402 471 4429 �CC SSCRETARY OF STATE y-�y Hall <br />, <br />�Og20�201 <br />�� <br />Form 668-H Depardnent of the Treasury - Intemal Revenue Service <br />Certificate of Refease of <br />�Rev October 2004) Federal Estate Tax Lien <br />area oRce <br />SB/SE #9 <br />Serial number <br />I certify that the requirements of section 6325(a) of the Intemal Revenue Code <br />have been satisfied for the tax liability (including all statutory additions) shown <br />below on the following-named estate. and that the lien for the ta�c and statutory <br />addidons has been released. The p � une 29 � Jul 8 Q office�v�e�e notice of <br />intemal revenue tax was filed on y , , <br />�5 <br />authorized to note in the books the relea as far as it refates to <br />the followring. �NST#2Q0406742 UCC#9904340367 2 <br />Name of Estate �state of John C. Davis <br />Name and address of agent designated by the qualified heirs for dealing with IRS <br />Daniel P. Davis <br />14960 W. Cedarview Road <br />Wood River, NE 68883 <br />Date of death <br />0401 <br />Decedant's s�ocial security number (SSI� <br />XXX-XX-8449 <br />(Far Opffonal Use by Reco�ng 0/flce) <br />99127 <br />DfiVIS <br />Filed: <br />e John H 6ele - UCC CRCTL <br />P, P9s: 1 <br />/2012 11:51 RPI <br />AmouM of additlonal tax <br />$ <br />Descriptlon of property to which lien attaches � <br />Qualifled Heirs: Francis T. Davis, John T. Davis, James D. Davis, Daniel P. Davis, Michael J. Davis. Kevin A. Davis and <br />Karen A. Rieke <br />The East Half of the Southeast Quarter (E1/2SE1/4) of Section Fourteen(14), Township Ten (10) North, Range Twelve (12) <br />West of the 6th P.M., Hall County, Nebraska <br />Place 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 />the 5 � � da of September 2012 <br />--� Y _ � <br />Signature ,�¢}� � � <br />�- - <br />Douc� Hottel #0682708 <br />Title <br />Part 3— To be kept by Recarding Office Catalog No.16744N <br />www.irs.gov Form 668-H (Rev.1 o-2ooa) <br />�005/005 <br />L' <br />I <br />i� <br />�L�' : <br />