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Notice of Federal <br />Tax Lien <br />Serial Number <br />(a) <br />Recording Information <br />(b) <br />Date Recorded <br />(c) <br />Taxpayer Identification Number <br />(d) <br />Amount Shown on Lien <br />(e) <br />773353411 <br />0201103043 <br />9911659528 -3 <br />04/21/2011 <br />xxx -xx -7020 <br />$12,716.18 <br />Form 669 -B <br />(September 2008) <br />201309286 <br />Department of the Treasury — Internal Revenue Service <br />Certificate of Discharge of Property From Federal Tax Lien <br />(Section 6325(b)(2)(A) of the Internal Revenue Code) <br />HEATHER E REIS of 4145 MANCHESTER RD, City of GRAND ISLAND, County of Hall, State of NEBRASKA, is indebted to the <br />United States for unpaid internal revenue tax in the sum of. Twelve Thousand Seven Hundred Sixteen and 18/100 Dollars <br />($12,716.18) as evidenced by: <br />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 <br />Register of Deeds, for the County of Hall, in accordance with the applicable provisions of law. <br />The lien listed above is attached to certain property described as: <br />Lot Forty Eight (48), Jeffrey Oaks Sixth Subdivision, in the City of Grand Island, Hall County, Nebraska <br />NOTE: Always include the address of real property or a descriptive narrative of personal property in this section when using <br />"See Attachment" and a more detailed description is being attached. <br />The Internal Revenue Service acknowledges receipt of Eight Thousand Five Hundred Ninety Two and 60/100 dollars <br />($8,592.6 %, the Internal Revenue Service discharges the above described property from the lien. However, the lien <br />remains in effect for all other property, or rights to property, to which the lien is attached. <br />Title <br />ADVISORY GRP MGR <br />Signature <br />KATHLEEN M KELM 4 <br />Catalog No. 16751C <br />Date <br />November 20, 2013 <br />(Note: Certificate of officer authorized by law to take acknowledgements is not essential to the validity of Discharge of <br />Federal Tax Lien. Rev. Rul. 71 -466, 1971 -2, C.B. 409.) <br />Form 669 - (Rev. 9 -2008) <br />