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05/29/2013 WED 15: 25 FAX 402 471 4429 UCC SECRETARY OF STATE -i--. Hall lJ002/002 <br /> CS 20 .E 304142 <br /> 3595 Department of the Treasury - Internal Revenue Service <br /> Form 668 (Z) <br /> (Rev. 10-2000) Certificate of Release of Federal Tax Lien <br /> Area: Serial Number For Use by Recording Office <br /> WAGE & INVESTMENT AREA #2 <br /> Lien Unit Phone: (800) 913-6050 850352212 <br /> I certify that the following-named taxpayer,under the requirements of section 6325(a) rE Sec of Sink Ja in a Oa a - u: -.NM <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 on March 01 <br /> 2012 , is authorized to note the books to show the release of this lien for • <br /> these taxes and additions. =1.:716 K Pss: <br /> IMEL KRISTTIN IN K <br /> Filed: 05/2912013 01:01 PM <br /> Name of Taxpayer • <br /> KRISTIN K IMEL <br /> Residence 643 MEVES AVE <br /> GRAND ISLAND NE 68801-7860 801 7860 <br /> • <br /> COURT RECORDING INFORMATION: <br /> Liber Page pLICC Ns. Serial No. <br /> n/a n/a 9912686242-2) 201201607 <br /> Tax Period Date of Last Day for Unpaid Balance <br /> Kind of Tax Ending Identifying Number Assessment Wiling of Assessment <br /> (a) (b) (Cl ldl (e) (f) <br /> 1040 12/31/2009 XXX-XX-8830 11/01/2010 12/01/2020 39934.43 <br /> Place of Filing <br /> Register of Deeds <br /> Hall POBOX 1692 Total $ 39934.43 <br /> Grand Island, NE 68802-1692 <br /> This notice was prepared and signed at CHICAGO, IL , on this, <br /> the 17th day of May , 2013 <br /> Signature ,\ C.4.9-,, Operations Manager, <br /> Centralized Case Processing-Lien Unit t• <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 /> P <br /> ( I <br /> art I -RECORDING OFFICE CAT. NO 600261 r40 <br />