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borne 668 (Z) <br />IRaY. 1 P>✓20001 <br />3595 Department of the Treasury - Internal Revenue Service 2015005 <br />Certificate of Release of Federal Tax lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED ARM #4 <br />Lien Unit Phone: (Soo) 913 -6050 <br />Serial Number <br />440821205 <br />For Use by Recording Office <br />gs Us as slake Joky, <br />11111 <br />91115744060-7 <br />91115744060-7 <br />Flied; PETERSON DONNA R <br />• <br />• gala <br />I <br />- UCC <br />II <br />CYFTL <br />II <br />I certify that the fallowing <br />of the Internat,.Revenue <br />additions. Therefore, <br />additions hat been <br />internal revenue tax <br />2008 , is authorized <br />- nerned taxpayer, <br />Code has <br />the lien provided <br />released. The <br />lien was flied <br />to note <br />under the requirements of section 0325 (a) <br />satisfied the taxes listed below and all statutory <br />by Code section 6321 for these taxes and <br />proper officer in the office where the notice of <br />on May 06 <br />: 4 <br />,asee nn <br />• <br />the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />GEORGE W & DONNA R PETERSON <br />• <br />Residence 19113 N GRAND ISLAND AVB <br />. GRAND ISLAND, NE 68803 -2740 <br />COURT RECORDING INFORMATION; <br />Liber Page 66- .Die -. —�� Serial No. <br />n/a n/a 9]QO]a0733 - ? .Z00003,00 <br />Kind of Tan <br />pi) <br />Tax Period <br />Ending <br />Identifying lumber <br />04 <br />Date of <br />Assessment <br />Las for <br />R + g . <br />12/0 / 2016 <br />12/05/2017 <br />** * *******T************** <br />Unpaid Balance <br />of Assessment <br />r 1 2 179.79 <br />5717.10 <br />** <br />• <br />• <br />1040 <br />1040 <br />****** *t******* <br />12/312005 <br />12/31/2006 <br />*f ft** <br />XXX -XX -7091 <br />XDC -21 -7091 <br />4* ir******* t** <br />11J06 2006 <br />11/05/2007 <br />o*•**'*ti lt*** ittt <br />Place of Filing <br />Register of Deeds <br />[!all POEM 1692 Total <br />Grand Island, NE 68802 -1692 <br />6 14896.89 <br />Jan. 26, 2015 2:45PM NE Secretary of State — UCC <br />No, 8840 P. 2 <br />This notice wee prepared and signed at CHICAGO, I L , on this, <br />the <br />Signature <br />05th day of January , 2015 , <br />Title Director, Specialty Collections <br />(NOM Certificate of officer authorized by law to take acknowledgments Is not essential to the validity of Certificate of Release of <br />Federal Tax lien Rev. flu!. 71 -466, 1971 - 2 C.B. 409) <br />Form fse (Z) (Rev. 10 -2000i <br />Part I - RECORDING OFFICE CAT. NO 60)261 <br />!1 Q <br />