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e • • 1 • Fprm 668 DEPARTMENT OP!THE TREASUirf.-INTERNAL REVENUE SERVICE For Optional Use By Recording Office (REV. 10-711 CERTIFICATE.OF RELEASE OF FEDERAL TAX LIEN ; DISTRICT SERIAL NUMBER . Omaha. Nebraska 28278 Enti.i.ed art numerical 1 I hereby certify that as to the following-named taxpayer the requirements of Section "nC1 r crd recorded on 6325(a); Internal Revenue Code, h..;c been satisfied with respect to the taxes enu- - ( y , 192‘.... mortared below, together with all statutory additions provided by Section 6321; and 7' % G4� that the lien for such taxes and statutory additions has thereby been released. The t,t ivii: as instrument proper officer in the office where notice,,,2f internal revenue tax lien was filed on I February 3. , 19 7¢J is hereby authorized to make notation No.?C -QOd/47... ... I on his books to show the release of said Dien,insofar as the lien relates to the follow- 1 ' ing faxes. • NAME OF TAXPAYER s. � vr I~ Jean F; h'cr t Z K. k g,. Merritt eistrclDeeds RESID CE Nag inty, ,•3ebrastca 9NWest'Charles Grand island.* Nebraska 64/801 UNPAID BALANCE KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUMBER OF ASSESSMENT (a) (b) (c) (d) (e) • 1040 12.-31-73 07-15.74 505-52-•2588 2„cn.3_'�b 76-000187 PLACL OF FILING Register. Of Deeds Cif ' a41 TOTAL $2,91114t76 Gra rer Z s Nebraska 68871 • ( WITNESS my hand at .Qmmaha ."lebras)Ca on this, • the 13th day of January .,, 1 , 76 SIGNATURE �__ TITLE • Donald Chlt ads �' Special Procedures ;)fficer (NOTE: Certificate of officer authorized by law to take acknowledgments is riot essential to the validity of Notice of Federal Tax Lien G.C.M. 26419,C.B. 1950-51, 125.1 • PART 3--To be used for recording purposes '.. • L L : " .