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201400507 Form S69-B ♦ Department of the Treasury-Internal Revenue Service (September 2008) Certificate of Discharge of Property From Federal Tax Lien (Section 6325(b)(2)(A)of the Internal Revenue Code) RICHARD & HEATHER SIEMERS of 3408 SCHROEDER AVE, 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 SEVENTY-THREE THOUSAND FIVE HUNDRED FIFTY-SEVEN DOLLARS AND SIXTY-EIGHT CENTS($73,557.68)as evidenced by: Notice of Federal Tax Lien Recording Information Date Recorded Taxpayer Identification Number Amount Shown on Lien Serial Number (b) (c) (d) (e) (a) 944141313 201305036 06/24/2013 xxx-xx-1698 $85,888.70 UCC filing # 9913717384-2 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 HALL COUNTY, in accordance with the applicable provisions of law. The lien listed above is attached to certain property described as: LOT TWO (2), BLOCK THREE (3), KNICKREHM FOURTH ADDITION TO 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 TWENTY-ONE THOUSAND SIX HUNDRED THIRTEEN DOLLARS AND THIRTY-ONE CENTS ($21,613.311, 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. Signature Title Date KATHLEEN M • • r ADVISORY GROUP MANAGER JANUARY 23,2014 (Note: Certificate of officer authorized by law to take acknowledgements is not essential to the validity of Discharge of Federal Tax Lien. Rev. Rul. 71-466, 1971-2, C.B. 409.) Catalog No. 16751C Form 669-B(Rev. 9-2008)