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F01111 668 (Z) <br />(Rev, 90 -2000) <br />11290 Department of the Treasury - Internal Revenue Service <br />2 0 1 5 0 f� 4 3 <br />Certificate of Release of Federal Tax Lien t e� <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (son) 913 -6050 <br />Serial Number <br />579421009 <br />For Use by Recording Office <br />NE sec of It. {r John R s.x. <br />- um clam <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 />I ' � <br />II <br />� <br />additions. Therefore, the lien provided by Code section 6321 for these taxes and <br />�,Ii <br />additions has been released. The proper officer in the office where the notice of <br />ai l, <br />internal revenue tax lien was filed <br />on September 15 <br />9915757406 <br />-2 Pgs: 1 <br />2009 <br />, is authorized to note <br />the books to show the release of this lien for <br />k Dr RRLD D <br />F11ed: etr ®er20is 11:10 an <br />these taxes and <br />additions. <br />Name of Taxpayer <br />DARRALD D JOHNSON <br />Residence 2114 W 2ND ST APT 247 <br />GRAND ISLAND,, NE 68803 -5310 <br />COURT RECORDING INFORMATION: <br />Liber Page <br />UCC No Serial <br />No. <br />n/a n/a <br />909607096 -9 200907500 <br />- <br />Tax Period <br />Date of <br />Last Day for <br />Unpaid Balance <br />Kind of Tax <br />Ending <br />Identifying Number <br />Assessment <br />Refiling <br />of Assessment <br />(a) <br />(b) <br />(c) <br />(d) <br />(e) <br />(f) <br />1040 <br />12/31/2003 <br />XXX -XX -0936 <br />07/07/2008 <br />08/06/2018 <br />2740.18 <br />1040 <br />12/31/2004 <br />XXX -XX- -0936 <br />07/27/2009 <br />08/26/2019 <br />3080.60 <br />1040 <br />12/31/2005 <br />XXX -XX -0936 <br />07/27/2009 <br />08/26/2019 <br />3578.18 <br />1040 <br />12/31/2006 <br />XXX -XX -0936 <br />07/27/2009 <br />08/26/2019 <br />344.75 <br />************************** <br />*** ****t*** <br />* ******* <br />************ <br />r********** ****** <br />• <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 Total <br />$ 9743.71 <br />Grand Island, NE 68802 -1692 <br />Jul. 9. 2015 2:51FM NE Secretary of State — UCC <br />//'' <br />D <br />N o. 1 71 8 F.,!6 <br />This notice was prepared and signed at CHICAGO, IL , on this <br />the <br />Signature <br />17th day of June <br />2015 <br />Title Director, Specialty Collections <br />(NOTE: 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. Rul. 71 -466, 1971 - 2 C.B. 40y) Form 668 (Z) (Rev. 10-2000) <br />0... _ ocenenti.e AEEff C <br />