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Form 6 68 (Z) <br />(Rev. 10 -2000) <br />2016 3:28PM <br />14742 <br />Area: <br />SMALL BUSINESS/ SELF EMPLOYED AREA '##4 <br />Lien Unit Phone: (800) 913 -6050 <br />Name of Taxpayer <br />JERRY L & CAROLE L DENTON <br />Kind of Tax <br />(a) <br />Place of Filing <br />Tax Period <br />Ending <br />( <br />1040:. 12/31/2004 <br />* * * * * * * * * * * * * * ** * ** <br />Identifying Number <br />(c) <br />'the. 17th day of : August 2016: <br />Signature <br />Department of the Treasury - Internal Revenue. Service <br />Certificate of Release of Federal Tax Lien <br />Serial Number <br />212754416 <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 : June 03 ' <br />2016 ; is authorized to note the books to show the release of this lien for <br />these taxes and additions. <br />Residence205. S CEDAR ST <br />GRAND .ISLAND; NE 68801 -6501 <br />COURT :..RECORDING .INFORMATION: <br />Libel Page. C No. Serial No. <br />n/a n/a 9916774820 -3 201603463 <br />Date of <br />Assessment <br />(d) <br />XXX -XX -3 010. 06 <br />* * * **** * * ** t* ** * * *. *, * * *** <br />Register ' of Deeds; <br />Hall :POBOX .:1692: <br />Grand Island, NE: 68802-1692 <br />This notice was prepared and signed at ` CHYCAGO, <br />East Day for <br />Ref) ittg <br />( <br />Total <br />3202 <br />(f) <br />201005738 <br />For Use by Recording Office.. <br />NE See of SE. +Er Jehd A Gda - UCC eRr74 <br />9916779362 -6 • Psis: t <br />DENTON GPROLE.L..• • <br />Filedi.0910112010 02;42 PM' <br />Unpaid. Balance <br />of Assessment <br />07,/05/2026 14758.91. <br />*, * *_ * * * * * * * **** * * * * * * ** * * *,* *** <br />1 4758 .9 1 <br />., on this, <br />Title.' Director'; . Specialt : y.:- 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.B. 409).: Form 668 (Z) lRev. 10-2000) <br />Part 1 - RECORDING OFFICE CAT, NO 600261 <br />