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Form 668 (Z) <br />(ne .,. tio-wva <br />Ares: <br />SHALL BUSINESS /SELF EMPLOYED AREA # <br />Lien Unit Phone: (80D) 913 -6050 <br />Name of Taxpayer <br />JAY B JULDS <br />Residence664 BISCHELD ST <br />GRAND ISLAND, Nis' 68801 -7895 <br />Liber Page <br />n/a n/a <br />Kind of Tax <br />(e) <br />Place of Filing <br />the <br />Sep. 29 2014 3:30PM NE Secretary of State — UCC <br />***ea*** <br />Signature <br />4804 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Tax Period <br />Ending <br />(6) <br />17th day of September , 2014 <br />Identifying Number <br />(a) <br />93 <br />Serial Number <br />989707214 <br />I certify that the following -named taxpayer, under the requirements of section 6325 (a) <br />of the Internal Revenue Code has satisfied the taxes listed below and all statutory <br />additions. Therefore, the lien provided by Code section 9321 for these taxes and <br />additions has been released. The proper officer in the office where the notice of <br />internal revenue tax lien was filed on March 28 <br />2014 is authorized to rote the books to show the release of thls Tien for <br />these taxes and additions. <br />COURT RECORDING INFORMATION: <br />Serial No. • <br />9914732970 -6 201401747 <br />Assessment <br />(d <br />06/03/2013 <br />**** * * * * *e * * ** * * * *** * * *4 ** * * * * * * *** <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />U for <br />(y <br />071- 93/2023 <br />** *wet * * * * * *iE <br />For Use by Recording Office <br />NE gas of stmt. J.h., A <br />11111 <br />6814742592 -6 <br />JUDOS JAY B <br />Filed; 09129/2014 09 :710 IM1 <br />Total <br />No.6967 P. 4/5 <br />This notice was prepared and signed at CHICAGO, IL <br />201406198 <br />ails - UCC awn <br />Psi; 1 <br />Unpaid Balance <br />of Assessment <br />( f) <br />1927.37 <br />* * *a * * * * * * *** *** <br />$ 1927.37 <br />on this, <br />Title <br />Operations Manager, <br />Centralized Case Processing -Lien Unit <br />(MOTE: Certificate of officer authorized by law to take acknowledgments le not eeeentiel to the validity of Certllioete of Release of <br />Federal Tax Tien Rev. Rul. 71 -486, 1971 - 2 C.B. 4091 Form 666 (Z) IRay. 10 -20001 <br />Part 1 - 1RECORDING 014112 GAT. NO 600261 i11V�1"J <br />