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Notice of Federal Tax Lien Serial Number • (a) Recording Information (b) Date Recorded (c) Taxpayer Identification Number (d) Amount Shown on Lien (e) 773353211 0201103041 9911659526 -9 04/21/2011 xxx -xx -7247 $12,716.18 Form 669 -B (September 2008) 201309285 Department of the Treasury - Internal Revenue Service Certificate of Discharge of Property From Federal Tax Lien (Section 6325(b)(2)(A) of the Internal Revenue Code) JEFFREY M REIS of 4145 MANCHESTER RD, City of GRAND ISLAND, County of Hall, State of NEBRASKA, is indebted to the United States for unpaid internal revenue tax in the sum of Twelve Thousand Seven Hundred Sixteen and 18/100 Dollars ($12,716.18) as evidenced by: A lien attaching to all the property of the taxpayer was filed to secure the amount owed. The notice of lien was filed with the Register of Deeds, for the County of Hall, in accordance with the applicable provisions of law. The lien listed above is attached to certain property described as: Lot Forty Eight (48), Jeffrey Oaks Sixth Subdivision, in the City of Grand Island, Hall County, Nebraska NOTE: Always include the address of real property or a descriptive narrative of personal property in this section when using "See Attachment" and a more detailed description is being attached. The Internal Revenue Service acknowledges receipt of Eight Thousand Five Hundred Ninety Two and 60/100 dollars ($8,592.69), the Internal Revenue Service discharges the above described property from the lien. However, the lien remains in effect for all other property, or rights to property, to which the lien is attached. Title ADVISORY GRP MGR Signature KATHLEEN M KEL 71tbet.heasLim ACEZeL Date November 20, 2013 (Note: Certificate of officer authorized by law to take acknowledgements is not essential to the validity of Discharge of Federal Tax Lien. Rev. Rut 71. 466, 1971 -2, C.B. 409.) Catalog No. 16751C Form 669 -B (Rev. 9 -2008)