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Jl.�u1, <br />Form 668 (Z) <br />(Rev. 10-2000) <br />Area: <br />SMALL BUSINESS /5EL4F EP'MPLO ED AREA *4 <br />Lien Unit Phone: (800) 913 -6050 <br />I certify that the following -named taxpayer, under the repuirements of section 8325 (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 />intemai revenue tax lien was filed on July 18 <br />2 0 07 , is authorized to note the books to show The release of this lien for <br />these taxes end additions. <br />Name of Taxpayer <br />ESTELLA E ADRIAN <br />Residence507 MEMORIAL DR <br />GRAND ISLAND, NE 68801 - 7854 <br />Liber Page <br />n/a n/0- <br />Kind of Taz <br />J0-) <br />1040 <br />1040 <br />1040 <br />1040 <br />1040 <br />•4** **t** <br />Place of Filing <br />This notice was prspered and signed at <br />the <br />Signature <br />20161a 4:03PM NE Secretary :f State — UCC No. 7292 F. 233 <br />2284 <br />Date of <br />Assessment <br />(d) <br />11/08/2004 <br />11/08/2004 <br />11/08/2004 <br />11/08/2004 <br />08/28/2006 <br />************************* T* t**** f'**** f•z** *****r * *r** ** ***it** ****** <br />Tax Period <br />Ending <br />(b) <br />12/31/1998 <br />12/31/1999 <br />12/31/2000 <br />12/31/2001 <br />12/31/2002 <br />22nd day of June <br />COURT R13COADING INFORMATION: <br />Serial No. <br />200706067 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802 -1692 <br />0 "4-- Op <br />Deperfment of the Treasury - Internal Revenue Service <br />201604287 <br />Certificate of Release of Federal Tax Lien <br />Identifying Number <br />It) <br />XXX -XX -8643 <br />XXX -XX -8643 <br />XXX-XX -8643 <br />XXX -XX -8643 <br />XXX-XX -8643 <br />2016 <br />Serial Number <br />376328807 <br />For Use by Recording Office <br />p E 5¢e of SAwie John A 6.10 • UCL CNFTL <br />9916776602 -3 Pas 1 <br />ADRIAN ESTELLA F <br />Filed: 07/00/2016 11:10 AM <br />last E ay for <br />Refil'mg <br />(el <br />12/08/2014 <br />12/08/2014 <br />12/08/2014 <br />12/08/2014 <br />09/27/2016 <br />Total $ <br />Unpaid Balance <br />of Assessment <br />657.10 <br />72662.22 <br />100669.18 <br />84438.52 <br />1418.36 <br />2S9845.38 <br />CHICAGO, IL , 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 In Rev RuI, 71 -466, 1971 - 2 C.B. 409) <br />Form 668 (Z) (Rev, 10 -20001 <br />7 r17A1 P 7i <br />