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Feb. 27. 2017 3 <br />Fly GG GCJ L aL • -.-. "V <br />Form 668 (Z) <br />IAev. 10.20001 <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 (al <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 August 05 <br />2010 , is authorized to note the books to show the release of this lien for <br />these taxes and additions_ <br />Name of Taxpayer <br />ANDREW DANNER <br />2284 Department of the Treasury - Internal Revenue Service <br />Certificate of Release of Federal Tax Lien <br />For Use by Recording Office <br />Residence 112 0 ORANGE RD <br />GRAND ISLAND, NE 68801 <br />Serial Number <br />COURT RECORDING IbNFORMATION; <br />Li.ber Page UC a. Serial No, <br />n/a n/a 9910633863 - 1J 201005499 <br />Kind of Tax <br />(al <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />941 <br />* * * * * *** * * * * * * * * * ** <br />Place of Filing <br />Tax Period <br />ending <br />(b) <br />03/31/2001 <br />06/30/2001 <br />09/30/2001 <br />12/31/2001 <br />06/30/2002 <br />09/30/2002 <br />12/31/2002 <br />03/31/2003 <br />06/30/2003 <br />09/30/2003 <br />Identifying Number <br />(c) <br />XX -XXX3 5 2 3 <br />XX- XXX3523 <br />XX- XXX3523 <br />XX -XXX3 523 <br />XX- XXX3523 <br />XX- XXX3523 <br />XX-XXX3523 <br />XX- XXX3523 <br />XX- XXX3523 <br />XX- XXX3523 <br />682055810 <br />Datc of <br />Assessment <br />(d) <br />02/09/2009 <br />04/13/2009 <br />02/02/2009 <br />02/02/2009 <br />02/02/2009 <br />02/02/2009 <br />02/02/2009 <br />02/09/2009 <br />02/02/2009 <br />02/09/2009 <br />Register of Deeds <br />Hall POBOX 1692 <br />Grand Island, NE 68802-1692 <br />Last Day for <br />Refiling <br />03/11/2019 <br />05/13/2019 <br />03/04/2019 <br />03/04/2019 <br />03/04/2019 <br />03/04/2019 <br />03/04/2019 <br />03/11/2019 <br />03/04/2019 <br />03/11/2019 <br />Total <br />This notice was prepared and signed at <br />CHICAGO, IL <br />the <br />09th d o f February , 2017, <br />Sig nature <br />2 1 .170 in <br />ME sec of irate �_ - <br />111111191 <br />Filed: 02!271201 a2:17 PSI <br />Unpaid Balance <br />of Assessment <br />3488.15 <br />10310.77 <br />16781.75 <br />30737.05 <br />36261.63 <br />18825.29 <br />18882.70 <br />16426.77 <br />10609.56 <br />282.80 <br />* * * * * ** * * * * * * * ** <br />162606.47 <br />, on this, <br />Title Director, specialty Collections <br />(NOTE: certificate of officer authorized by law to take eoknowledgments is not essential to the validity of Certificate of Release of <br />Federal Tax lien Rev. Rul. 71 - 466, 1971 - 2 C.B 4091 Form 668 (2) IRev. 10 -2000) <br />Part 1 - RECORDING OFFICE I. al" kin cnnoci <br />