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` � y, <br /> � � � • ..... w-� � <br />_ �::a'.' <br />;a1+M1t';,: <br />'.�;�z.•!: <br /> v:^,�i <br />�t�i;i <br />�S�� -- _ <br /> z r;, . . . . . . � <br /> z�; <br />���� -- <br /> r � Fom�068 DEP?P,iMCNi OF TI1E Ti:iA5Uk7-ItJif7NAl REVENUE SFilV1CF. F�r Oplicnnl Use B�Rnnrd ny O�iice � <br />��: (eeV.i o-n 1 CERTIfICATE OF REtEASE Of FEDERdI TAX tIEN <br /> fz�r.; <br /> �,, DISTRICT SERIAL NUM6ER 30386 <br />'::,�:' �IDAt18 1Q8}?I`88�9 <br />' ' I hereby ceriify thot as lo the following•named toxpaycr fhe ieyuiremeNs of Sedion <br /> 6325(oJ, Internal Revenue Code, have been satisfied with resped to the tar.es env- <br />��' merated 6elow, logel'ner with all stafutory additions provided by Sr_�tion 6321;and <br />,'�S`� that ihe lien for such taxes and stalutory additions has Ihereby been releosed.The <br /> ` proper afficet m the ofPice where noticey miernal revenue tax lien was filed on <br />�?`, (�dV 12 , 19/�:,i,hereby aulhorized lo niake nolation <br /> on his books to show ihe relea.e of said lien,insofar as ihe lien relates to th�follow- <br /> � . ing taxes. �� � <br /> -�. NAME OP TAXPAYER <br /> Galen L. iioftl�n <br />�. P.ESIDENCE <br />� Rt 3, Box 1�3� �racu3 Island Airport <br /> ' Grand IeZand, Ftebra�ka 6$802 <br /> UNPAID BALANCE <br /> KIND OF TAX TAX PERIOD ENDED DATE OF ASSESSMENT IDENTIFYING NUN�BER OP ASSESSMENT <br /> (a� �b� ��) ��� {e) <br /> 941 O9-3t�-75 o3-2g-?6 t}5-o27a2z3 �1,39�.62 <br /> c <br /> ," I 76_ ��6 �� <br /> I <br />�� <br />��. <br />�� <br />� � + <br />��±� PLACE OF FILING ���t@i, � ���$ <br /> ��� � COlititiJ7 OF H3�.1 ?OTAL 5 �.f�g(j�(jL <br />,��� � Gra.nd I31and, H@braska b6£3�1 � <br />����. � <br />�, <br />���� `NITTJESS my hand or Omahd, (�ebraska <br /> --- . .. <br />���: <br /> F=�`�� rhe�lLday ot October , i9. 76 <br />•`.^'`h;. <br /> i?�"� <br />�� � <br /> i�. <br />�s� SIGNATUP,E � �',/� TITLE <br />�� C_�-�-�i���'C�,�, �:fC!CC_- I <br />�r���' Donald J. EhYers � Special Procedures Officer <br /> i:�n;'� <br />;�.',7�;��.. (NOTE:Certifcete ef o�ccr���F,orized by I�w to tn�c ac'r.nowlc�yments,nc!cr.e.nhal lo the.veiidny of F:o!i:e of Fedcial?os��cn G.Cfd. <br />;�;5: 26419,C.B. 1950-51, 1:5.) <br /> a{;;� <br />�;,# I PART 3-To bo usod for recording purposes <br />'r4�' <br /> g'',;:';a�. <br />;?7,=r: <br />���,�'. <br />�°4''x,`r ' : _ .. <br /> _ iNr <br /> r i � � J � . <br /> �� <br /> : � <br /> J; � <br /> � � <br />'�::;;;! <br /> !� � J <br />