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Form 668 (Z) <br />(Rev. 10 -2000) <br />3595 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />798504011 <br />For Use by Recording Office <br />NE Sec of State John A Gale - U CC CRFTL <br />I certify that the following -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 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 <br />on July 21 <br />2011 , is authorized <br />to note <br />the books to show the release of this lien for <br />9913709868 -8 PgS: 1 <br />POTTER WM <br />these taxes and additions. <br />Filed: 03/04/2013 01:35 PM <br />Name of Taxpayer <br />WM POTTER <br />Residence 920 S LOCUST ST <br />GRAND ISLAND, NE 68801 -6768 <br />COURT RECORDING INFORMATION: <br />Liber Page Serial No. <br />n/a n/a 9911667180 -5 0201105347 <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(dl <br />(e) <br />(f) <br />1040 <br />12/31/2002 <br />XXX -XX -8643 <br />08/15/2005 <br />09/14/2015 <br />18124.23 <br />1040 <br />12/31/2003 <br />XXX -XX -8643 <br />10/27/2008 <br />11/26/2018 <br />46659.84 <br />1040 <br />12/31/2005 <br />XXX -XX -8643 <br />11/16/2009 <br />12/16/2019 <br />15879.59 <br />1040 <br />12/31/2006 <br />XXX -XX -8643 <br />11/16/2009 <br />12/16/2019 <br />6864.24 <br />1040 <br />12/31/2007 <br />XXX -XX -8643 <br />03/14/2011 <br />04/13/2021 <br />2596.72 <br />************* <br />* * * * * * * <br />* * * * * * * * * ** * *x <br />* * * * * *** ** <br />* * * * * * * * * * * ** <br />* * * * * * * * * * * * * * ** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 90124.62 <br />Grand Island, NE 68802 -1692 <br />03/04/2013 MON 14:12 FAX 402 471 4429 UCC SECRETARY OF STATE - -- Hall <br />the <br />Signature <br />20th day of February , 2013 <br />0005/006 <br />201301712 <br />This notice was prepared and signed at CHICAGO, IL , on this, <br />Title <br />Operations Manager, <br />Centralized Case Processing -Lien Unit <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) Form 668 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />