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.!un.9u 2016 9 96FM NE 'Secretary of state — UCC <br />Form 668 (Z) <br />(Rev. 10 -20001 <br />Area: <br />SMALL BUSINESS /SELF EMPLOYED AREA If <br />Lien Unit Phone: (600) 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 Jantiaryr 06 <br />2016 , is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Name of Taxpayer <br />SERGIO CALDERON GUTIERRE <br />Residence523 ROUSH LN <br />GRAND ISLAND, NE 68801 -2210 <br />Liber Page <br />n/a n/a <br />Kind of Tax <br />( <br />1040 <br />1040 <br />1040 <br />* * * * * * ** <br />Place of Filing <br />the <br />Signature <br />5216 Department of the Treasury - Internal Revenue Service <br />COURT RECORDING INFORMATION: <br />►• Serial No. <br />9916766191 -8 201600068 <br />Tax Period <br />Ending <br />(b4 <br />Identifying Number <br />(c) <br />12/31/2005 XXX -XX -3766 12/22/2014 <br />12/31/2006 XXX- XX-3766 01/12/2015 <br />12/31/2007 XXX -XX -3766 12/22/2014 <br />This notice was prepared and signed at <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />15th day of June , 2016 <br />64tA—t 6"1111' <br />Certificate of Release of Federal Tax Lien <br />Serial Number <br />190205115 <br />Date of <br />Assessment <br />(d) <br />CHICAGO, IL <br />Last Day for <br />Reffng <br />(e) <br />For Use by Recording Office <br />NS Sec DI 14e4. 'Om <br />N �I <br />No. 7216 F. <br />201604058 <br />a u[ [ ft TL <br />9916775149 -1 Pfle. <br />GUT ERRE SERGIO CALDERON <br />Filed: 06/30/2016 01:Se PM <br />Unpaid Balance <br />of Assessment <br />(f) <br />01/21/2025 2580,83 <br />02/11/2025 2535.53 <br />01/21/2025 2256.55 <br />* * * * * * * * * * * *v ** * * * * * * * * * * * * ** <br />Total $ 7372.91 <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. Rut. 71 -466, 1971 - 2 C.B. 4-09) <br />Part I RECORDING OFFICE Form 668 (Z) (Rev. 10 - 2000) <br />CAT. NO 600201 <br />