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Form 668 (z) <br />5216 Department of the Treasury - Internal Revenue Service 2016003' <br />Certificate of Release of Federal Tax Lien <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA # <br />Lien Unit Phone: (800) 913 -6050 <br />Serial Number <br />478800067 <br />For Use by Recording Office <br />NE <br />En. of <br />9918767041 <br />BROCK RANDY <br />Filed; <br />Sta4. <br />0712112016 <br />- 2 <br />L <br />Jahn R 0.10 UGC GRFTL <br />1 <br />' lf � <br />' Peg: <br />03:46 All <br />1 <br />I certify that the <br />of the Internal <br />additions_ Therefore, <br />additions has <br />internal revenue <br />1987 _ <br />following -named taxpayer, <br />Revenue Code has <br />the lien provided <br />been released. The <br />tax lien was filed <br />, is authorized to note <br />additions. <br />under the requirements of section 6325 (a) <br />satisfied the taxes listed below and all statutory <br />by Code section 8321 for these taxes and <br />proper officer in the office where the notice of <br />on February 25 <br />y <br />the books to show the release of this lien for <br />these taxes and <br />Name of Taxpayer <br />RANDY L. BROCK <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 87- 101032 <br />Kind of Tax <br />(a) <br />Tax Period <br />Ending <br />(6) <br />identifying Number <br />(c) <br />Date of <br />Assessment <br />(d) <br />Last Day for <br />Refiling <br />( e) <br />Unpaid Balance <br />of Assessment <br />( f ) <br />1040 <br />1040 <br />1040 <br />1040 <br />** ** * ** * <br />12/31/1980 <br />12/31/1981 <br />12/31/1982 <br />12/31/1983 <br />* * * * ** * * * * * <br />XXX -XX -7127 <br />XXX -XX -7127 <br />XXX -XX -7127 <br />XXX -XX -7127 <br />** * *, ******************** <br />06/16/1986 <br />06/16/1986 <br />06/23/1986 <br />06/16/1986 <br />07/16/1992 <br />07/16/1992 <br />07/23/1992 <br />07/16/1992 <br />* * * * ** * * ** *** <br />3345.92 <br />4961.19 <br />4548.92 <br />4335.31 <br />** * * **** * ** * *>*r ** <br />Jan. 21. 2016 3:23FM NE Se::retary of State — UCC <br />Place of Filing <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />This notice was prepared and signed at Omaha NE , on this, <br />the <br />Signature <br />10th day of January , 2016 <br />Total <br />No, 4704 F. 5/7 <br />17191.34 <br />Title Director, Specialty Collections <br />(NOTE: Certificate of officer authorized by law to take acknowledgmanta Is not essential to the validity of Certificate of Release of <br />Federal Tax lien flee. Rul. 71466, 1971 - 2 C.B. 4091 Form 666 (Z) (Rev. 10 - 20001 <br />Part t - RECORDING OFFICE CAT. NO 600261 <br />7 <br />