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Jan. 21. 2016 3:23PM NE Secretary of State - UCC No. 4704 <br />Form 668 (Z) <br />IRsv. 10 -20001 <br />Name of Taxpayer <br />RANDY L . BROCK <br />Kind of Tax <br />a <br />1040 <br />1040 <br />1040 <br />* ** *fir *** <br />Place of Filing <br />5216 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA #4 <br />Lien Unit Phone: (800) 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 and all statutory <br />additions_ Therefore, the lien provided by Code section 6321 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 July 01 _ <br />1996 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />ResidenceR D 1, BOX. 277 <br />GRAND ISLAND, NE 68801 <br />COURT RECORDING INFORMATION: <br />Liber Page UCC No. Serial No. <br />n/a n/a n/a 96- 105161 <br />Tax Period Date of <br />Ending Identifying Number Assessment <br />b (c) (d) <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE <br />the 10th day of January , 2016 <br />Signature [pn� <br />Serial Number <br />479601519 <br />NE <br />Last Day for <br />Refing <br />201600395 <br />For Use by Recording Office <br />Sea of El. <br />Jelin A eele <br />euiu <br />9916787043-6 <br />BROCK RANDY L <br />Filed: 51/21/2016 09:45 AM <br />- DEC CRFTL <br />1, i <br />II� <br />Pgs <br />Unpaid Balance <br />of Assessment <br />If) <br />12/31/1981 XXX -XX -7127 06/16/1986 N/A 4961.19 <br />12/31/1982 XXX -XX -7127 06/23/1986 N/A 4548.92 <br />12/31/1983 XXX -XX -7127 06/16/1986 N/A 4335.31 <br />*********** *** * * *****x ** ** ** **** *** * * * * * ** Ott * * * ****** * ** ** * ** * *** <br />Total $ 13845.42 <br />This notice was prepared and signed at . Omaha NE , 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. Rut. 71 -460, 1971 - 2 C.B. 409) Form 660 (Z) (Rev. 10 -2000) <br />Part 1 - RECORDING OFFICE CAT. NO 600261 <br />