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201508186
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12/3/2015 8:12:16 AM
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12/3/2015 8:12:16 AM
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DEEDS
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201508186
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Dec. 2. 2015 3:09PM NE Secretary of State — UCC <br />, NOV - 30 - 2015 08 :35 <br />Form 668 (Z) <br />(Aev. 10 -20001 <br />Area: <br />SMALL BUSINESS /SELF 84PLOXED AREA 46 <br />Lien Unit Phone: (80o) 913 - 6050 <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 end all statutory <br />additions. Therefore, the lien provided by Code section 8321 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 June 16 <br />2010 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />DONALD ID & JUDITH L HERZOG <br />Residence 3 9.15 CONRAD DR <br />GRAND ISLAND NE 68801 <br />Liber <br />n/a <br />Kind of Tax <br />(a) <br />1040 <br />* * * * * * ** <br />Place of Filing <br />the <br />2284 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />For Use by Recording Office <br />COURT RECORDING INFORMATION: <br />Page jC No S erial No. <br />n/a 9910630079 - 201004192/201202 <br />Tax Period <br />Ending <br />(b) <br />12 /31/2006 <br />* ** * * * * * * ** <br />This notice was prepared and signed at <br />Identifying Number <br />(c,? <br />XXX -XX -9153 <br />Register of Deed <br />Hall POBOX 1692 <br />Grand Island, NB 68802 -1692 <br />lath day of November , 2015. <br />Signature <br />* * * * * * * * * * * * * ** ** * * * * *** *** <br />Serial Number <br />6651.79910 <br />Date of <br />Assessment <br />(d) <br />04/15/2010 <br />CHICAGO, XL <br />r <br />No 3862 P. 3/4 <br />j..,� P, 02 <br />Ka <br />a <br />Lan Day for <br />Reflu ng <br />(e) <br />05/15/2020 <br />* * * *** ** * ** <br />UCC cnsT- <br />1111111111 <br />99157E -1 <br />Pigs: 1 <br />HERZOG DONALD D <br />Filed: 12!07!2015 01;45 PM <br />Total <br />Unpaid Balance <br />of Assessment <br />( <br />9338.50 <br />* * * * * *w * * * * * * * ** <br />9338.50 <br />, on this, <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.e. 409) Form 668 (Z) (Rev. 10- 2000) <br />
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