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Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />923589213 <br />For Use by Recording Office <br />NE Sc <br />11 <br />9913714930 <br />KLEIN <br />Filed: <br />a of <br />KRISTEN <br />s!e!a <br />©5/10/2013 <br />- 8 <br />John <br />F <br />q Gala <br />11:26 <br />- UGC <br />P s <br />RN <br />RFT <br />1 <br />f <br />I certify that the following -named taxpayer, <br />of the Internal Revenue Code has <br />additions. Therefore, the lien provided <br />additions has been released. The <br />internal revenue tax lien was filed <br />2 013 , is authorized to note <br />under the requirements of section 6325 (a) <br />satisfied the taxes listed below and all statutory <br />by Code section 6321 for these taxes and <br />proper officer in the office where the notice of <br />on March 04 <br />the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />KRISTEN F KLEIN <br />Residence 17541 <br />CAIRO, <br />Liber Page <br />n/a n/ <br />W AIRPORT <br />NE 68824 <br />CO <br />No. <br />9913709866-A <br />RD <br />-9538 <br />CORDING <br />Serial <br />201301710 <br />INFORMATION: <br />No. <br />/ <br />Kind of Tax <br />(a) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refiling <br />(e1 <br />Unpaid Balance <br />of Assessment <br />(f) <br />Tax Period <br />Ending <br />(b) <br />Identifying Number <br />(C) <br />1040 <br />**** plc***** <br />12/31/2009 <br />Cllr** <br />XXX -XX -5548 <br />******'*******T*** <br />11/05/2012 <br />** ** *'A****** <br />12/05/2022 <br />qtr **'* ***gtrw <br />80973.16 <br />***k'********** ** <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />Grand Island, NE 68802 -1692 <br />$ 80973.16 <br />05/10/2013 FRI 11:54 FAX 402 471 4429 UCC SECRETARY OF STATE <br />i l ) Form 668 (Z) <br />(Rev. 10 -2000) <br />This notice was prepared and signed at <br />the 17th day of April <br />Signature <br />(NOTE: Certificate of officer authorized <br />Federal Tax lien Rev. Rul, 71 -466, 1971 <br />Hall <br />1x1002 /002 <br />3595 Department of the Treasury - Internal Revenue Service 201303754 <br />Certificate of Release of Federal Tax Lien <br />CHICAGO, IL <br />on this, <br />2013. <br />Title <br />Operations Manager, <br />Centralized Case Processing -Lien Unit <br />by law to take acknowledgments is not essential to the validity of Certificate of Release of <br />- 2 C.B. 409) Form 668 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />